Organization
WILLOW HEALTH AND AESTHETICS LLC
Active
Other names
Willow Medical Spa for Women LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA L HIGGINS (OWNER)
(541) 653-9158
Entity
Organization
Contact information
Practice address
1030 WILLAGILLESPIE RD, EUGENE, OR 97401-2123
(541) 653-9158
Mailing address
1030 WILLAGILLESPIE RD, EUGENE, OR 97401-2123
(541) 653-9158
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD22056
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134307
—
OR
01
—
149865
MEDICARE
OR
Enumeration date
11/16/2011
Last updated
09/07/2017
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