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NPI Code Detail

MEDICARE: MS. RAEGAN NAMORE LANCASTER LMT

MEDICARE: MS. RAEGAN NAMORE LANCASTER 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 Therapist29369OR

General Provider Information

NPI Number : 1861350134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RAEGAN NAMORE LANCASTER LMT
Provider Business Mailing Address
First Line : 5803 SW SALMON ST
Second Line :
City : PORTLAND
State : OR
Zip : 97221-1563
Country : US
Telephone Number : 563-505-5175
Fax Number :
Provider Business Practice Location Address
First Line : 5308 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97206-2962
Country : US
Telephone Number : 503-775-6885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2026
Last Update Date : 01/14/2026

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