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General NPI Number Information
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NPI Number | 1730061870
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Entity Type | Organization
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Legal Business Name | EMILY MERCER BEAUTY, LLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 1428 SE 19TH AVE STE D
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City | PORTLAND
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State | OR
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Zip | 97214-4516
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Country | US
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Telephone | 541-740-7973
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 SE MADISON ST APT 103
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City | PORTLAND
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State | OR
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Zip | 97214-4590
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Country | US
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Telephone | 541-740-7973
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY MERCER
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Credential |
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Telephone | 541-740-7973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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