Healthcare Provider Details

I. General information

NPI: 1235091125
Provider Name (Legal Business Name): AMELIA ROSE ZUBRINICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEX ROSE ZUBRINICH

II. Dates (important events)

Enumeration Date: 11/29/2025
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 E POWELL BLVD STE 102
GRESHAM OR
97030-8013
US

IV. Provider business mailing address

1733 E POWELL BLVD STE 102
GRESHAM OR
97030-8013
US

V. Phone/Fax

Practice location:
  • Phone: 503-740-6343
  • Fax: 971-405-8004
Mailing address:
  • Phone: 503-740-6343
  • Fax: 971-405-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29355
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: