NPIMap

Organization Active NPI

Phoenix Services, Inc.

Doing business as Spa Willamina

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1588919062
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
PHOENIX SERVICES, INC.
Doing business as
Spa Willamina
Practice address
1928 NE 40TH Ave
Portland, OR 97212-5310
Phone
(503) 287-2787
Fax
(503) 546-0667
NPI assigned
Jul 19, 2012
Last updated
Jul 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Authorized official

Name
Mrs. Willow Light
Title
Owner
Phone
(503) 287-2787

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

1928 NE 40TH Ave
Portland, OR 97212-5310

Mailing address

1928 NE 40TH Ave
Portland, OR 97212-5310
Phone (503) 287-2787

Other names 1

  • Spa Willamina Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1588919062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125310",
            "telephone_number": "503-287-2787",
            "fax_number": "503-546-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125310",
            "telephone_number": "503-287-2787",
            "fax_number": "503-546-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "WILLOW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-287-2787",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spa Willamina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.