Spark of Life, LLC

NPI #1093426132 in Woodburn, Oregon

Provider Information

NPI Number: 1093426132
Entity Type: Organization
Organization Name: Spark of Life, LLC
Primary Specialty: Massage Therapist
Enumeration Date: Dec 9, 2022
Last Updated: Dec 9, 2022

Practice Location

Address: 564 RAY J GLATT CIRCLE
City: Woodburn
State: Oregon
ZIP Code: 97071
Phone: (971) 707-2506

Authorized Official

Name: MISS TAMARA J HAMMACK, MPH, LMT
Title: DIRECTOR/OWNER
Phone: (971) 707-2506

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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