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NPI Code Detail

MEDICARE: MARIANNE CRISTIN OBER LMT

MEDICARE: MARIANNE CRISTIN OBER 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
1225700000XMassage Therapist17709OR

General Provider Information

NPI Number : 1962705962
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE CRISTIN OBER LMT
Provider Business Mailing Address
First Line : 2947 NE FLANDERS ST APT 2
Second Line :
City : PORTLAND
State : OR
Zip : 97232-3290
Country : US
Telephone Number : 505-690-9803
Fax Number :
Provider Business Practice Location Address
First Line : 2330 NW FLANDERS ST STE 101
Second Line :
City : PORTLAND
State : OR
Zip : 97210-3400
Country : US
Telephone Number : 503-701-8766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2010
Last Update Date : 12/13/2010

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Directions to “ MARIANNE CRISTIN OBER LMT” Practice Location

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