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Organization
SPARK OF LIFE, LLC
Active
Organization
SPARK OF LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TAMARA J HAMMACK MPH, LMT (DIRECTOR/OWNER)
(971) 707-2506
Entity
Organization
Contact information
Practice address
564 RAY J GLATT CIRCLE, WOODBURN, OR 97071
(971) 707-2506
Mailing address
PO BOX 337, WOODBURN, OR 97071-0337
(971) 707-2506
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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