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General NPI Number Information
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NPI Number | 1073751020
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Entity Type | Individual
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Provider Name | DEBORA K NELLI LMT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 7417 SW BEAVERTON HILLSDALE HWY STE 200
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City | PORTLAND
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State | OR
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Zip | 97225-2100
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Country | US
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Telephone | 503-291-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 4070 SW 107TH AVE # 7
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City | BEAVERTON
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State | OR
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Zip | 97005-3171
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Country | US
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Telephone | 425-802-3809
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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 | 13645
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License Number State | OR
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