Organization
NEOGENISIS HOLISTIC HEALTH & WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WENDY LYNN LILJA-HOLBROOK LMT (OWNER/THERAPIST)
(503) 380-5222
Entity
Organization
Contact information
Practice address
2045 SE WASHINGTON STREET, MILWAUKIE, OR 97222
(503) 380-5222
Mailing address
2045 SE WASHINGTON STREET, MILWAUKIE, OR 97222
(503) 380-5222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10827
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10827
LMT LICENSE
OR
Enumeration date
02/12/2009
Last updated
02/12/2009
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