MEDICARE: ARIANA ANONUEVO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	29717	OR

General Provider Information

NPI Number	:	1124950159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA ANONUEVO

Provider Business Mailing Address
First Line	:	1650 NW 13TH AVE APT 523
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-3697
Country	:	US
Telephone Number	:	415-341-7618
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 NW 13TH AVE APT 523
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-3697
Country	:	US
Telephone Number	:	415-341-7618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ ARIANA ANONUEVO ” Practice Location

Language	Start Address	Practice Location

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