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
251K00000X
Public Health or Welfare Agency
Primary
21991
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21991
SPECIALIST
OR
Enumeration date
05/24/2016
Last updated
05/24/2016
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