1. Home
  2. Directory
  3. Oregon
  4. Ashland
  5. Massage Therapist
  6. NPI Profile

BREEANNA WALLACE LMT, MLD-C
NPI 1790325470
Massage Therapist in Ashland, OR

Active since January 10, 2020
180 CLEAR CREEK DR STE 104, ASHLAND, OR 97520(907) 978-8989 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Breeanna Wallace Lmt, Mld-c NPPES

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

BREEANNA WALLACE LMT, MLD-C (NPI 1790325470) is an individual massage therapist in Ashland, Oregon, licensed in Oregon (27902) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1790325470
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameBREEANNA WALLACECredential: LMT, MLD-C
Location Address180 CLEAR CREEK DR STE 104Ashland, OR 97520-1993
Mailing Address180 Clear Creek Dr Ste 104Ashland, OR 97520-1993 · (907) 978-8989 · Fax (907) 451-9168
Phone(907) 978-8989
Sole ProprietorNo
Enumeration DateJanuary 10, 2020
Last NPPES UpdateApril 30, 2025
NPPES CertifiedApril 30, 2025
✔ NPI 1790325470 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
License✔ Licensed in OR · 27902
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.
180 CLEAR CREEK DR STE 104, Ashland, OR 97520
Open in Google Maps ↗

Other Identifiers 1

Other1437273125Npi

Other Providers at the Same Location NPPES 5

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

KITCHEN TABLE COUNSELING
Community/Behavioral Health
180 CLEAR CREEK DR STE 104
ASHLAND, OR 97520
Jackson County (541) 500-8655
CENTER FOR CHINESE MEDICINE, PC
Acupuncturist
180 CLEAR CREEK DR STE 104
ASHLAND, OR 97520
Jackson County (541) 482-7071
LAVENDER & LULL THERAPEUTIC MASSAGE LLC
Massage Therapist
180 CLEAR CREEK DR STE 104
ASHLAND, OR 97520
Jackson County (907) 978-8989
JODY HERRIOTT L.AC.
Acupuncturist
180 CLEAR CREEK DR STE 104
ASHLAND, OR 97520
Jackson County (541) 621-3378
MR. KEN BENDAT L.AC.
Acupuncturist
180 CLEAR CREEK DR STE 104
ASHLAND, OR 97520
Jackson County (541) 482-7071

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 Breeanna Wallace's NPI number?

The NPI number for Breeanna Wallace is 1790325470. It was assigned to this individual provider in the NPPES registry on January 10, 2020.

Where is Breeanna Wallace located?

Breeanna Wallace practices at 180 Clear Creek Dr Ste 104, Ashland, OR 97520. The listed phone number is (907) 978-8989.

What is Breeanna Wallace'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 Breeanna Wallace was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.