Neogenisis Holistic Health & Wellness, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

10827 Issued in OR

Legal business name

NEOGENISIS HOLISTIC HEALTH & WELLNESS, LLC

Practice address

2045 SE Washington Street
Milwaukie, OR 97222

Phone

(503) 380-5222

NPI assigned

Feb 12, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Wendy Lynn Lilja-Holbrook, LMT

Title

Owner/Therapist

Phone

(503) 380-5222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1235378332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 SE WASHINGTON STREET",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "503-380-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 SE WASHINGTON STREET",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "503-380-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGENISIS HOLISTIC HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "LILJA-HOLBROOK",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "503-380-5222",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "10827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT LICENSE",
            "identifier": "10827",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neighborhood Health Center
• Jerrry C Nelner, OTRL
• Brian Nelson, CADC I
• Rebecca Nelson, OTRL
• Sandre Sue Nelson, CERTIFIED OCCUPATION
• Kimberley Arianne Neroda, MD
• Julie Lynne Ness
• Amanda Lee Neubig
• New Vision Programs of Oregon
• Newbridge Health, Inc.

• Massage Therapist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.