Active Wellness Center LLC
Active Wellness Center LLC is a healthcare organization registered as Massage Therapist in Bend, OR, holding Type 2 (organization) NPI 1205779089 since 2026. The authorized official on file is Mark Dejohn, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1205779089 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Active Wellness Center LLC |
| Practice address | 593 NW YORK DR, Bend, OR, 97703 |
| Phone | 5419480993 |
| Enumeration date | 2026-04-14 |
| Last updated in NPPES | 2026-04-14 |
Authorized official
| Name | Mark Dejohn |
|---|---|
| Title | Owner |
| Phone | 5419480993 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 225700000X | Massage Therapist | Primary | — | — |
Copy-ready billing details
Provider: Active Wellness Center LLC NPI: 1205779089 Taxonomy: 225700000X (Massage Therapist) Address: 593 NW YORK DR, Bend, OR, 97703
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1154644599 | Mark Dejohn | Individual | Massage Therapist | Bend, OR |
| 1386064764 | Sean Stradley | Individual | Professional Counselor | Bend, OR |
| 1467838755 | Nicole Gricius | Individual | Mental Health Counselor | Bend, OR |
| 1114531480 | Kimberly Johnson | Individual | Speech-Language Pathologist | Bend, OR |
| 1891443578 | Dayna English | Individual | Speech-Language Pathologist | Bend, OR |
Verify this record
Cross-check NPI 1205779089 against the authoritative CMS record: view Active Wellness Center LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Active Wellness Center LLC located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-04-14.