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NPI Code Detail

MEDICARE: DAZY MONIQUE VELASCO RAMIREZ LMT

MEDICARE: DAZY MONIQUE VELASCO RAMIREZ LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist20431OR

General Provider Information

NPI Number : 1316663230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAZY MONIQUE VELASCO RAMIREZ LMT
Provider Business Mailing Address
First Line : 2993 NW GLENCOE RD
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-1521
Country : US
Telephone Number : 971-888-9751
Fax Number :
Provider Business Practice Location Address
First Line : 2343 SE TUALATIN VALLEY HWY
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-7976
Country : US
Telephone Number : 503-868-4792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2022
Last Update Date : 10/12/2022

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