Healthcare Provider Details

I. General information

NPI: 1427987056
Provider Name (Legal Business Name): LIANNA TUMBEIRO DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIANNA JUAREZ TUMBEIRO

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21860 WILLAMETTE DR
WEST LINN OR
97068-3256
US

IV. Provider business mailing address

16533 NE HALSEY ST APT 403
PORTLAND OR
97230-6199
US

V. Phone/Fax

Practice location:
  • Phone: 503-650-2394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29259
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: