Provider Demographics
NPI:1104223957
Name:HEALING HANDSMASSAGE AND BODYWORK
Entity type:Organization
Organization Name:HEALING HANDSMASSAGE AND BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIA (WILLOW)
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MUHR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-997-6847
Mailing Address - Street 1:1511 HESS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-9579
Mailing Address - Country:US
Mailing Address - Phone:503-997-6847
Mailing Address - Fax:503-538-9679
Practice Address - Street 1:1511 HESS CREEK CT
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-9579
Practice Address - Country:US
Practice Address - Phone:503-997-6847
Practice Address - Fax:503-538-9679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7971302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1649483710OtherCHP