Healthcare Provider Details

I. General information

NPI: 1609615426
Provider Name (Legal Business Name): CHELSEA GRAJEDA DAVIS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 SW HAMPTON ST STE 140
TIGARD OR
97223-8375
US

IV. Provider business mailing address

7100 SW HAMPTON ST STE 140
TIGARD OR
97223-8375
US

V. Phone/Fax

Practice location:
  • Phone: 971-413-0493
  • Fax: 503-776-7830
Mailing address:
  • Phone: 971-413-0493
  • Fax: 503-776-7830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18541
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: