Healthcare Provider Details

I. General information

NPI: 1881503621
Provider Name (Legal Business Name): CORINNE LAZO LMT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8147 SW SENECA ST
TUALATIN OR
97062-8416
US

IV. Provider business mailing address

8147 SW SENECA ST
TUALATIN OR
97062-8416
US

V. Phone/Fax

Practice location:
  • Phone: 503-869-7470
  • Fax: 971-358-8082
Mailing address:
  • Phone: 503-869-7470
  • Fax: 971-358-8082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CORINNE LAZO
Title or Position: OWNER
Credential: LMT
Phone: 503-869-7470