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WILLAMETTE WINE SPA LLC
NPI 1740159532
Massage Therapist in Portland, OR

Active since October 31, 2025
1517 NE BROADWAY ST, PORTLAND, OR 97232(503) 946-8450 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Willamette Wine Spa Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLAMETTE WINE SPA LLC (NPI 1740159532) is a healthcare organization registered as a massage therapist in Portland, Oregon and active in the NPI registry since October 2025. The organization lists Kelly Lewis, Founder, as its authorized official.

NPPES Registry Identity

NPI1740159532
Entity TypeOrganization
Primary Taxonomy225700000X
Legal Business NameWILLAMETTE WINE SPA LLC
Location Address1517 NE BROADWAY STPortland, OR 97232-1406
Mailing Address1838 Ne Wasco StPortland, OR 97232-1444
Phone(503) 946-8450
Organization SubpartNo
Authorized OfficialKelly LewisFounder · (808) 341-1583
Enumeration DateOctober 31, 2025
NPPES CertifiedOctober 31, 2025
✔ NPI 1740159532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
Definition
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.
1517 NE BROADWAY ST, Portland, OR 97232
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMIE TINSLEY-SHANNON ROLAN LMT
Massage Therapist
1517 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 946-8450

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willamette Wine Spa LLC's NPI number?

The NPI number for Willamette Wine Spa LLC is 1740159532. It was assigned to this organization in the NPPES registry on October 31, 2025.

Where is Willamette Wine Spa LLC located?

Willamette Wine Spa LLC is located at 1517 NE Broadway St, Portland, OR 97232. The listed phone number is (503) 946-8450.

What is Willamette Wine Spa LLC's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Willamette Wine Spa LLC was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.