Soully Aware LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

SOULLY AWARE LLC

Doing business as

Soully Aware

Practice address

1733 E Powell Blvd Ste 102
Gresham, OR 97030-8013

Phone

(503) 740-6343

Fax

(503) 974-3744

NPI assigned

Feb 8, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Danielle Tkacik, LMT 26808NPI 1932840535

Title

Ceo

Phone

(503) 740-6343

Specialties & licenses 1

Addresses

Other names 1

• Soully Aware Doing business as

Locations

Practitioners 3

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

• Danielle Lee Tkacik, LMT

  • Massage Therapist
  • Gresham, OR
  • NPI 1932840535

  Single Specialty

  NPD Authorized official
• Christine Nicholas-Jenani

  • Massage Therapist
  • Gresham, OR
  • NPI 1922978808
  NPD
• Amelia Rose Zubrinich

  • Massage Therapist
  • Gresham, OR
  • NPI 1235091125
  NPD

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1780448878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 E POWELL BLVD STE 102",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308013",
            "telephone_number": "503-740-6343",
            "fax_number": "503-974-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 E POWELL BLVD STE 102",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308013",
            "telephone_number": "503-740-6343",
            "fax_number": "503-974-3744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 NE Wood Village Blvd Ste 23",
            "address_purpose": "LOCATION",
            "city": "Wood Village",
            "state": "OR",
            "postal_code": "970602668",
            "country_code": "US",
            "telephone_number": "503-740-6343",
            "fax_number": "503-974-3744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "335 S Broadway St",
            "address_purpose": "LOCATION",
            "city": "Estacada",
            "state": "OR",
            "postal_code": "97023",
            "country_code": "US",
            "telephone_number": "503-740-6343",
            "fax_number": "503-974-3744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1722 NW Raleigh St Ste 417",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972091753",
            "country_code": "US",
            "telephone_number": "503-740-6343",
            "fax_number": "503-974-3744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOULLY AWARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "TKACIK",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-740-6343",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT 26808"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soully Aware",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Soully Aware",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.