Provider Demographics
NPI:1386980027
Name:OPEN HANDS MASSAGE THERAPY, LLC
Entity type:Organization
Organization Name:OPEN HANDS MASSAGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-724-0550
Mailing Address - Street 1:PO BOX 2661
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-2661
Mailing Address - Country:US
Mailing Address - Phone:503-724-0550
Mailing Address - Fax:503-723-5112
Practice Address - Street 1:2008 WILLAMETTE FALLS DR
Practice Address - Street 2:STE 200A
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4658
Practice Address - Country:US
Practice Address - Phone:503-724-0550
Practice Address - Fax:503-723-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18010225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty