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NPI Code Detail

MEDICARE: MS. TRACY LYNN BELK LMT

MEDICARE:  MS. TRACY LYNN BELK  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 Therapist

General Provider Information

NPI Number : 1467634790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACY LYNN BELK LMT
Provider Business Mailing Address
First Line : 4536 SE 97TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97266-2642
Country : US
Telephone Number : 503-351-6091
Fax Number :
Provider Business Practice Location Address
First Line : 4035 SE 52ND AVE STE B
Second Line :
City : PORTLAND
State : OR
Zip : 97206-3913
Country : US
Telephone Number : 503-774-4099
Fax Number : 503-774-0106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2007
Last Update Date : 11/28/2007

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Directions to “ MS. TRACY LYNN BELK LMT” Practice Location

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