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General NPI Number Information
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NPI Number | 1346179546
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Entity Type | Individual
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Provider Name | NICOLE LLORENS MONTESERIN LMT
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Gender | Female
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 5200 S MACADAM AVE STE 300
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City | PORTLAND
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State | OR
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Zip | 97239-3808
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Country | US
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Telephone | 503-446-4226
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Fax |
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Provider Business Mailing Address
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Address Line | 4231 SE 33RD PL
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City | PORTLAND
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State | OR
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Zip | 97202-3446
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Country | US
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Telephone | 787-448-5537
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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 | 26583
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License Number State | OR
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