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General NPI Number Information
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NPI Number | 1205716289
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Entity Type | Organization
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Legal Business Name | BEAVERTON ADVANCED THERAPEUTICS
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 10700 SW BEAVERTON HILLSDALE HWY STE 550
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City | BEAVERTON
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State | OR
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Zip | 97005-4740
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Country | US
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Telephone | 971-217-6004
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Fax | 503-296-2774
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Provider Business Mailing Address
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Address Line | 10700 SW BEAVERTON HILLSDALE HWY STE 550
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City | BEAVERTON
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State | OR
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Zip | 97005-4740
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Country | US
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Telephone | 971-217-6004
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Fax | 503-296-2774
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | JESSICA KING
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Credential | LMT
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Telephone | 971-217-6004
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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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