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NPI Code Detail

MEDICARE: MS. SALLY JO ARMSTRONG LMT, CA, NCTMB

MEDICARE: MS. SALLY JO ARMSTRONG LMT, CA, NCTMB
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
1225700000XMassage Therapist#O6234OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
197124OTHERORMULTIPLE INS. #'S

General Provider Information

NPI Number : 1669593299
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SALLY JO ARMSTRONG LMT, CA, NCTMB
Provider Business Mailing Address
First Line : PO BOX 185
Second Line :
City : BEAVERTON
State : OR
Zip : 97075-0185
Country : US
Telephone Number : 503-225-9033
Fax Number : 503-225-9039
Provider Business Practice Location Address
First Line : 4425 SW CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4260
Country : US
Telephone Number : 503-225-9033
Fax Number : 503-225-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 07/08/2007

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