Organization
GRESHAM THERAPEUTIC MASSAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HOARD (OWNER)
(503) 492-3910
Entity
Organization
Contact information
Practice address
1748 NW FAIRVIEW DR, GRESHAM, OR 97030-3842
(503) 492-3910
(503) 674-6706
Mailing address
1748 NW FAIRVIEW DR, GRESHAM, OR 97030-3842
(503) 492-3910
(503) 674-6706
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18265
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223
AUTO AND MEDICAL INSURANCE
OR
Enumeration date
07/18/2014
Last updated
07/18/2014
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