Jessica Bach, LMT
Individual provider Active NPI Massage Therapist · Milwaukie, OR
NPI 1073159661 · NPPES record last updated Nov 19, 2019
Key facts
- NPI
- 1073159661
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 17392 (OR)
- Practice address
- 3365 SE Floss St
Milwaukie, OR 97222-5636 - Phone
- (503) 314-7746
- NPI assigned
- Nov 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17392 | OR | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 17392 | OR | Yes |
Addresses
Primary practice location
3365 SE Floss St
Milwaukie, OR 97222-5636
Mailing address
3365 SE Floss St
Milwaukie, OR 97222-5636
Phone (503) 314-7746
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17392 | Other | MASSAGE LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.spagoddesspdx.com | Direct |
Other providers in Milwaukie, OR
- Ashley Nicole Avila
- Artur Azizkhanian
- B & B Residential Care Services, LLC
- Amber Johnson Babar
- Daya Babariya
- Thomas Edward Bachhuber Jr.
- Cherry M Bachmeier
- Sunhee Baek
- Jeannie Marie Baer
- Michael Santos Bagalso
All providers in Milwaukie, OR · Massage Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.