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NPI Code Detail

MEDICARE: SYLVIA ALLRED LMT, LMP

MEDICARE: SYLVIA ALLRED LMT, LMP
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 Therapist13920OR

General Provider Information

NPI Number : 1720212459
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYLVIA ALLRED LMT, LMP
Provider Business Mailing Address
First Line : 2726 NE ALBERTA ST
Second Line :
City : PORTLAND
State : OR
Zip : 97211-6349
Country : US
Telephone Number : 503-282-1710
Fax Number :
Provider Business Practice Location Address
First Line : 2915 NE BROADWAY ST
Second Line :
City : PORTLAND
State : OR
Zip : 97232-1776
Country : US
Telephone Number : 503-734-0594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2009
Last Update Date : 05/10/2009

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Directions to “ SYLVIA ALLRED LMT, LMP” Practice Location

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