MEDICARE: REBECCA JEAN ORFORD 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
1	225700000X	Massage Therapist	22641	OR

General Provider Information

NPI Number	:	1467981191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA JEAN ORFORD LMT

Provider Business Mailing Address
First Line	:	4325 NE HALSEY ST APT 14
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213-1556
Country	:	US
Telephone Number	:	406-239-5297
Fax Number	:

Provider Business Practice Location Address
First Line	:	4160 NE SANDY BLVD # 1100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-5336
Country	:	US
Telephone Number	:	503-249-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2017
Last Update Date	:	06/06/2017

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