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NPI Code Detail

MEDICARE: DANYELLE MARIE TINKER LOWDER LMT

MEDICARE:   DANYELLE MARIE TINKER LOWDER  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 Therapist18597OR

General Provider Information

NPI Number : 1447528054
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANYELLE MARIE TINKER LOWDER LMT
Provider Business Mailing Address
First Line : 5575 NE SANDYCREST TER APT 3
Second Line :
City : PORTLAND
State : OR
Zip : 97213-2646
Country : US
Telephone Number : 503-881-4786
Fax Number :
Provider Business Practice Location Address
First Line : 1785 NE SANDY BLVD
Second Line : SUITE 290
City : PORTLAND
State : OR
Zip : 97232-2850
Country : US
Telephone Number : 503-208-6717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2011
Last Update Date : 12/02/2014

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Directions to “ DANYELLE MARIE TINKER LOWDER LMT” Practice Location

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