MEDICARE: LISA M FINSTER L.M.T.

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	17439	OR

General Provider Information

NPI Number	:	1518260850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA M FINSTER L.M.T.

Provider Business Mailing Address
First Line	:	10817 SW 121ST AVE
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-3342
Country	:	US
Telephone Number	:	971-998-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 NW 185TH AVE STE 100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-3492
Country	:	US
Telephone Number	:	971-998-6262
Fax Number	:

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

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	06/25/2021

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