Provider Demographics
NPI:1699174276
Name:ALI OGLE, LMT
Entity type:Organization
Organization Name:ALI OGLE, LMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:OGLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-607-0018
Mailing Address - Street 1:2008 WILLAMETTE FALLS DR STE 200A
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4673
Mailing Address - Country:US
Mailing Address - Phone:503-607-0018
Mailing Address - Fax:503-723-5112
Practice Address - Street 1:2008 WILLAMETTE FALLS DR STE 200A
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4673
Practice Address - Country:US
Practice Address - Phone:503-607-0018
Practice Address - Fax:503-723-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11485302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization