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Organization
SOULLY AWARE LLC
Active
Organization
SOULLY AWARE LLC
Active
Other names
Soully Aware
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DANIELLE TKACIK LMT 26808 (CEO)
(503) 740-6343
Entity
Organization
Contact information
Practice address
1733 E POWELL BLVD STE 102, GRESHAM, OR 97030-8013
(503) 740-6343
(503) 974-3744
Mailing address
1733 E POWELL BLVD STE 102, GRESHAM, OR 97030-8013
(503) 740-6343
(503) 974-3744
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
05/15/2024
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