MEDICARE: ARADIA SUNLIGHT

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	6628	OR

General Provider Information

NPI Number	:	1275788531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARADIA SUNLIGHT

Provider Business Mailing Address
First Line	:	1626 NE ALBERTA ST STE A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-5048
Country	:	US
Telephone Number	:	503-287-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 NE ALBERTA ST STE A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-5048
Country	:	US
Telephone Number	:	503-287-1444
Fax Number	:

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

Provider Enumeration Date	:	11/28/2008
Last Update Date	:	08/31/2022

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Directions to “ ARADIA SUNLIGHT ” Practice Location

Language	Start Address	Practice Location

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