Soully Aware LLC

NPI #1780448878 in Gresham, Oregon

Provider Information

NPI Number: 1780448878
Entity Type: Organization
Organization Name: Soully Aware LLC
Primary Specialty: Massage Therapist
Enumeration Date: Feb 8, 2024
Last Updated: May 15, 2024

Practice Location

Address: 1733 E POWELL BLVD STE 102
City: Gresham
State: Oregon
ZIP Code: 97030-8013
Phone: (503) 740-6343

Authorized Official

Name: MS. DANIELLE TKACIK, LMT 26808
Title: CEO
Phone: (503) 740-6343

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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