NPI 1104401421 · live from the CMS NPI Registry
Neifa Dolores Alonso, LMT
Massage Therapist in Portland, OR. National Provider Identifier 1104401421, active.
NPI record
| NPI | 1104401421 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 12741 Ne Halsey St, Portland, OR 97230 |
| Practice phone | 503-255-0306 |
| Mailing address | Po Box 82, Newberg, OR 97132 |
| Enumerated | March 17, 2021 |
| Last updated | February 2, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist | 225700000X | MA61137617 (WA) |
| Massage Therapist primary | 225700000X | 24711 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.