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Active NPI 1780448878 Organization (Entity Type 2)

Soully Aware Llc

Massage Therapist • Gresham, OR

About Soully Aware Llc NPI 1780448878 Summary

Soully Aware Llc is a verified healthcare organization specializing in Massage Therapist operating in Gresham, OR. Located at 1733 E POWELL BLVD STE 102, this facility provides patient care and medical services under National Provider Identifier (NPI) 1780448878.

Administrative operations and authorized compliance are overseen by Danielle Tkacik (Ceo).

The facility is associated with 3 linked healthcare practitioners providing clinical services. In addition to its main center, the organization maintains 3 secondary practice locations in the region.

Facility Location & Contact Primary Location

Facility Address

1733 E Powell Blvd Ste 102

Gresham, OR 970308013

Telephone 5037406343

Fax 5039743744

Authorized Official Information

Authorized Contact Name

MS. Danielle Tkacik , LMT 26808

Title / Role

Ceo

Official Telephone

5037406343

Facility Classifications & Specialties

Massage Therapist Primary Taxonomy

NUCC Taxonomy Code: 225700000X

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.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

3 Linked

Amelia Zubrinich NPI 1235091125

Massage Therapist

Gresham, OR

View Practitioner Profile →

Christine Nicholas-Jenani NPI 1922978808

Massage Therapist

Gresham, OR

View Practitioner Profile →

Danielle Tkacik , LMT NPI 1932840535

Massage Therapist

Gresham, OR

View Practitioner Profile →

Secondary Facility Locations

Verified branch offices, satellite clinics, and regional practice locations

3 Branches

1722 Nw Raleigh St Ste 417

Portland, OR 972091753

Phone: 5037406343

1110 Ne Wood Village Blvd Ste 23

Wood Village, OR 970602668

Phone: 5037406343

335 S Broadway St

Estacada, OR 97023

Phone: 5037406343

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

8 Historical Events

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Updated Practice Location May 15, 2024

Registered at 1733 E POWELL BLVD STE 102, GRESHAM, OR 970308013 (Tel: 5037406343)

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Updated Business Mailing Address May 15, 2024

Registered at 1733 E POWELL BLVD STE 102, GRESHAM, OR 970308013 (Tel: 5037406343)

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NPI Profile Active February 08, 2024

NPI status registered as active in NPPES database

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Updated Practice Location February 08, 2024

Registered at 1110 NE WOOD VILLAGE BLVD STE 23, WOOD VILLAGE, OR 970602668 (Tel: 5037406343)

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Updated Business Mailing Address February 08, 2024

Registered at 37603 RACHAEL DR, SANDY, OR 970556331 (Tel: 5037406343)

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Organization / Clinic Name Updated February 08, 2024

Operating as SOULLY AWARE LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2024

Massage Therapist

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Initial NPI Registration & Enumeration February 08, 2024

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

0 Reviews

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NPI Organization Metadata

NPI Number: 1780448878

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: February 08, 2024

Last Update: May 15, 2024

Update or Correct Listing

Mailing Address

1733 E Powell Blvd Ste 102

Gresham, OR 970308013

Phone: 5037406343

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.