Healthcare Provider Details

I. General information

NPI: 1811283534
Provider Name (Legal Business Name): ADRIAN RAMON BELTRAN LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5519 HOVANDER RD UNIT 101
FERNDALE WA
98248-9865
US

IV. Provider business mailing address

1300 W SAM HOUSTON PKWY S STE 300
HOUSTON TX
77042-2453
US

V. Phone/Fax

Practice location:
  • Phone: 360-318-7097
  • Fax: 360-464-4875
Mailing address:
  • Phone: 360-318-7097
  • Fax: 360-464-4875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.60179110
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: