Healthcare Provider Details

I. General information

NPI: 1780855387
Provider Name (Legal Business Name): MARIA ANDREA MONTERA LMT, RMTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2008
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
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

PO BOX 2017
HILLSBORO OR
97123-1918
US

V. Phone/Fax

Practice location:
  • Phone: 503-882-8081
  • Fax:
Mailing address:
  • Phone: 503-882-8081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8313
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: