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General NPI Number Information
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NPI Number | 1013473735
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Entity Type | Individual
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Provider Name | SONJA ROSE-PARKS
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 444 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1856
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Country | US
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Telephone | 503-740-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 986 BRIDGE ST
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City | LAFAYETTE
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State | OR
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Zip | 97127-9174
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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