Provider Demographics
NPI:1952615304
Name:TMC, LLC
Entity Type:Organization
Organization Name:TMC, LLC
Other - Org Name:THE MASSAGE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MASSAGE THERAPIST- CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIESE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-620-1474
Mailing Address - Street 1:7360 SW HUNZIKER ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8288
Mailing Address - Country:US
Mailing Address - Phone:503-620-1474
Mailing Address - Fax:503-639-9526
Practice Address - Street 1:7360 SW HUNZIKER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8288
Practice Address - Country:US
Practice Address - Phone:503-620-1474
Practice Address - Fax:503-639-9526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty