Organization
CERES AND LUNA HOLISTIC SPA LLC
Active
Other names
Ceres and Luna Holistic Spa LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANELLE EVETTE GRIZZARD LMT (OWNER)
(480) 586-7859
Entity
Organization
Contact information
Practice address
3821 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-1114
(503) 289-1390
Mailing address
3821 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-1114
(503) 289-1390
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
202D00000X
Integrative Medicine Physician
—
—
225700000X
Massage Therapist
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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