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NPI Code Detail

MEDICARE: NANCY ELLEN LAUKA LMT

MEDICARE: NANCY ELLEN LAUKA 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 Therapist7104OR

General Provider Information

NPI Number : 1326870700
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY ELLEN LAUKA LMT
Provider Business Mailing Address
First Line : 1327 SE TACOMA ST # 157
Second Line :
City : PORTLAND
State : OR
Zip : 97202-6639
Country : US
Telephone Number : 503-233-9874
Fax Number :
Provider Business Practice Location Address
First Line : 7886 SE 13TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97202-6300
Country : US
Telephone Number : 503-956-9396
Fax Number : 503-206-4791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2024
Last Update Date : 08/19/2024

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Directions to “ NANCY ELLEN LAUKA LMT” Practice Location

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