Provider Demographics
NPI:1841184124
Name:BIG HEART HOME MASSAGE AND HEALING ARTS LLC
Entity type:Organization
Organization Name:BIG HEART HOME MASSAGE AND HEALING ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:480-227-2486
Mailing Address - Street 1:6405 SW PROSPECT CT
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97078-4318
Mailing Address - Country:US
Mailing Address - Phone:480-227-2486
Mailing Address - Fax:
Practice Address - Street 1:1975 NW 167TH PL STE 100-46
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4908
Practice Address - Country:US
Practice Address - Phone:971-217-6420
Practice Address - Fax:971-423-0886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty