MEDICARE: DANIEL AKINS 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	16914	OR

General Provider Information

NPI Number	:	1710246442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL AKINS L.M.T.

Provider Business Mailing Address
First Line	:	5331 SW MACADAM AVE
Second Line	:	STE 258-550
City	:	PORTLAND
State	:	OR
Zip	:	97239
Country	:	US
Telephone Number	:	503-410-3776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1722 NW RALEIGH ST # 315
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-1753
Country	:	US
Telephone Number	:	503-410-3776
Fax Number	:

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

Provider Enumeration Date	:	05/15/2012
Last Update Date	:	08/01/2019

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