Healthcare Provider Details

I. General information

NPI: 1427193259
Provider Name (Legal Business Name): TAMARA MARIE FELIX PHD, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 06/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 NE ELAM YOUNG PKWY A
HILLSBORO OR
97124-6498
US

IV. Provider business mailing address

5215 NE ELAM YOUNG PKWY A
HILLSBORO OR
97124-6498
US

V. Phone/Fax

Practice location:
  • Phone: 503-693-9101
  • Fax: 503-693-9123
Mailing address:
  • Phone: 503-693-9101
  • Fax: 503-693-9123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number5352
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberCERTIFICATION
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: