Vitality Spa LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

VITALITY SPA LLC

Practice address

4380 Cherry Ave NE
Keizer, OR 97303-4855

Phone

(503) 479-7111

NPI assigned

Aug 21, 2025

Organization subpart

No

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

Authorized official

Name

Paul R Garcia, CAENPI 1316825128

Title

Owner/Advanced Aesthetician

Phone

(503) 479-7111

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Richard Garcia, CAE

  • Other Technician
  • Keizer, OR
  • NPI 1316825128
  NPD Authorized official

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1417835232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034855",
            "telephone_number": "503-479-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034855",
            "telephone_number": "503-479-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/ADVANCED AESTHETICIAN",
        "authorized_official_telephone_number": "503-479-7111",
        "authorized_official_credential": "CAE"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan David Vanderburg, L.M.T
• Zoe Vasas, LMT
• Alma Denise Vera, RDH
• Kathy Ann Verboort, COTA/A
• Stephanie Lynn Vieu, M.S., LPC, CADC II
• Ethan Vosburgh, DPT
• Margaret Diane Wade, MSW, LCSW
• Walgreen Co
• Stephen Dale Walter, DC
• Jeffrey T Wang, M.D.

• Medical Specialty Clinic/Center in Keizer, OR
• Providers in Keizer, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.