Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Wild Moss Wellness LLC

Organization Massage Therapist · NPI 1407607633

Wild Moss Wellness LLC is a Massage Therapist in Portland, Oregon. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

529 SE Grand Ave Ste 300D
Portland, OR 97214-2232
Phone: (503) 410-3013
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X

Record details

NPI number1407607633
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kiya Tenney — Owner · (507) 676-3180
NPI enumeratedMarch 27, 2024
Last updated in NPPESMarch 27, 2024
Certification dateMarch 27, 2024
Mailing address529 Se Grand Ave Ste 300d, Portland, OR 97214-2232

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