Healthcare Provider Details

I. General information

NPI: 1699687566
Provider Name (Legal Business Name): JOSI L BERTLING LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 SW SPRING GARDEN ST STE 100
PORTLAND OR
97219-3966
US

IV. Provider business mailing address

10511 SW 42ND AVE
PORTLAND OR
97219-6959
US

V. Phone/Fax

Practice location:
  • Phone: 503-841-6222
  • Fax:
Mailing address:
  • Phone: 850-420-7413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29769
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: