# ACTIVE WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972151595
- **Authorized official:** PEGGY STEIN (OT/OWNER)
- **Authorized official phone:** (541) 286-5445

## Contact information

- **Practice address:** 120 SW 4TH ST STE 170, CORVALLIS, OR 97333-4896
- **Practice address phone:** (541) 286-5445
- **Practice address fax:** (800) 527-4735
- **Mailing address:** 2135 NW EVERGREEN ST, CORVALLIS, OR 97330-1109
- **Mailing address phone:** (541) 829-9505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/27/2019
- **Last updated:** 08/27/2019