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NPI Code Detail

MEDICARE: MS. PENNY LYNN HILL L.M.T.

MEDICARE:  MS. PENNY LYNN HILL  L.M.T.
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 Therapist4527OR

General Provider Information

NPI Number : 1376553701
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PENNY LYNN HILL L.M.T.
Provider Business Mailing Address
First Line : 4120 NE AINSWORTH CT
Second Line :
City : PORTLAND
State : OR
Zip : 97211-7943
Country : US
Telephone Number : 503-493-5954
Fax Number :
Provider Business Practice Location Address
First Line : 4120 NE AINSWORTH CT
Second Line :
City : PORTLAND
State : OR
Zip : 97211-7943
Country : US
Telephone Number : 503-493-5954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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Directions to “ MS. PENNY LYNN HILL L.M.T.” Practice Location

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