Healthcare Provider Details

I. General information

NPI: 1518260850
Provider Name (Legal Business Name): LISA M FINSTER L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 06/25/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 NW 185TH AVE STE 100
PORTLAND OR
97229-3492
US

IV. Provider business mailing address

10817 SW 121ST AVE
TIGARD OR
97223-3342
US

V. Phone/Fax

Practice location:
  • Phone: 971-998-6262
  • Fax:
Mailing address:
  • Phone: 971-998-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number17439
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: