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General NPI Number Information
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NPI Number | 1831852110
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Entity Type | Individual
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Provider Name | ARON NOVA DANIELS LMT
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Gender |
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 333 NE HANCOCK ST STE 13
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City | PORTLAND
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State | OR
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Zip | 97212-3941
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Country | US
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Telephone | 971-801-0430
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Fax | 888-388-2469
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Provider Business Mailing Address
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Address Line | 1817 NE WEIDLER ST APT 1
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City | PORTLAND
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State | OR
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Zip | 97232-1491
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Country | US
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Telephone | 971-801-0430
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Fax | 888-388-2469
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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 | 25507
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License Number State | OR
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