1750624698 NPI number — TARIA ANN PIROZZI L.M.T.

Table of content: TARIA ANN PIROZZI L.M.T. (NPI 1750624698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750624698 NPI number — TARIA ANN PIROZZI L.M.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIROZZI
Provider First Name:
TARIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.M.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750624698
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10175 SW TRAPPER TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAVERTON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97008-7814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-933-3495
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7110 SW FIR LOOP
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-8084
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-639-2243
Provider Business Practice Location Address Fax Number:
503-746-7432
Provider Enumeration Date:
03/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171W00000X , with the licence number:  13654 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13654 . This is a "OREGON MASSAGE LICENSE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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