PERFORMANCE BODYWORK LLC NPI 1811302607

NPI Information

NPI: 1811302607
Provider Name: PERFORMANCE BODYWORK LLC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Doing Business As: SURGE WELLNESS
Address: 2188 SW PARK PL
SUITE 10
PORTLAND, OR
ZIP 97205
Phone: (503) 568-1390

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NPI Details

PERFORMANCE BODYWORK LLC is a massage therapist in Portland, OR. The provider is 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. PERFORMANCE BODYWORK LLC NPI is 1811302607. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Surge Wellness.

The provider's business location address is:

2188 SW PARK PL
SUITE 10
PORTLAND, OR
ZIP 97205-100
Phone: (503) 568-1390

The provider's authorized official is Casey Holliman .
The authorized official title is President and has the following contact phone number (503) 568-1390.

The enumeration date for this NPI number is 7/1/2014 and was last updated on 7/25/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	111N00000X	Chiropractor		No
2	171100000X	Acupuncturist		No
3	225700000X	Massage Therapist		Yes
4	261QM1300X	Clinic/Center	Multi-Specialty	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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