MEDICARE: MRS. TANYA J WARD LMT

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	7329	OR

General Provider Information

NPI Number	:	1669514139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANYA J WARD LMT

Provider Business Mailing Address
First Line	:	10700 SW BVT HLDL HWY STE 450
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-4736
Country	:	US
Telephone Number	:	503-819-9685
Fax Number	:

Provider Business Practice Location Address
First Line	:	10700 SW BVT HLDL HWY STE 450
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-4736
Country	:	US
Telephone Number	:	503-819-9685
Fax Number	:

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	03/12/2020

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