Pacific Northwest Wellness LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

PACIFIC NORTHWEST WELLNESS LLC

Practice address

106 E 16TH Ave
Eugene, OR 97401-4033

Phone

(971) 266-0421

NPI assigned

May 16, 2019

Organization subpart

No

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

Authorized official

Name

Priscilla MycoNPI 1346542503

Title

Owner

Phone

(719) 266-0421

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Priscilla Myco

  • Nurse Practitioner
  • Eugene, OR
  • NPI 1346542503

  Massage Therapist

  NPD Authorized official

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1437715216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E 16TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014033",
            "telephone_number": "971-266-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E 16TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014033",
            "telephone_number": "971-266-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MYCO",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-266-0421"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346542503",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pacific Plastic Surgery PC
• Pacific Sky Counseling
• Pacific Sports and Interventional Spine, LLC-P
• Pacific Surgery Center LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.