Organization · Type 2 NPI

Revivanation LLC

Massage Therapist · Portland, OR

NPI number 1629490388 Active

Practice location

914 SW 11th Ave
Portland, OR 97205-2001

Call (503) 765-5333 Map

Fax (888) 495-4549

Specialties and licenses

TaxonomyCodeLicense
Acupuncturist 171100000XAC01286 (OR)
Massage Therapist Primary 225700000X17523 (OR)
Massage Therapist 225700000X13830 (OR)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1629490388

Revivanation LLC's National Provider Identifier is 1629490388, issued on Jan 15, 2014. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Jan 15, 2014.