| Blooming Moon Wellness Spa Inc. | |
|
1920 N Killingsworth St, Portland, OR 97217-4437 | |
| (971) 279-2757 | |
| Not Available |
| Full Name | Blooming Moon Wellness Spa Inc. |
|---|---|
| Type | Facility |
| Speciality | Massage Therapist |
| Location | 1920 N Killingsworth St, Portland, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144574096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 69864495 (Oregon) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Blooming Moon Wellness Spa Inc. 1920 N Killingsworth St, Portland, OR 97217-4437 Ph: (971) 279-2757 | Blooming Moon Wellness Spa Inc. 1920 N Killingsworth St, Portland, OR 97217-4437 Ph: (971) 279-2757 |
Heidi Stachelrodt, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 503-866-9271 Fax: 971-386-1281 | |
Stephanie R Shevy, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 9055 Sw Beaverton Hillsdale Hwy, Ste A, Portland, OR 97225 Phone: 503-644-4664 Fax: 503-644-9005 | |
Colleen Mcclenahan, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 7409 Sw Capitol Hwy Ste 206, Portland, OR 97219 Phone: 503-816-4179 | |
Sunshine Welsch, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, 7d19, Portland, OR 97239 Phone: 503-494-8349 Fax: 503-494-6783 | |
Chung So, LMT(OREGON #4132) Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1616 Se Bybee Blvd, Portland, OR 97202 Phone: 503-236-4654 | |
Joelle Anne Cappello, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1928 Ne 40th Ave, Portland, OR 97212 Phone: 503-287-2787 | |
Mrs. Monicka April Koneski, LMT, RYT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1235 Se Division St, Suite 203b, Portland, OR 97202 Phone: 503-319-8056 |