NPI 1194057745 · live from the CMS NPI Registry
Ivan Abarzua, LMT
Massage Therapist in Portland, OR. National Provider Identifier 1194057745, active.
NPI record
| NPI | 1194057745 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 10535 Ne Glisan St, Portland, OR 97220 |
| Practice phone | 503-261-1120 |
| Mailing address | 4127 Se Flavel St, Portland, OR 97202 |
| Enumerated | February 8, 2010 |
| Last updated | February 8, 2010 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 8168 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.