1427193259 NPI number — DR. TAMARA MARIE FELIX PHD, LMT

Table of content: DR. TAMARA MARIE FELIX PHD, LMT (NPI 1427193259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427193259 NPI number — DR. TAMARA MARIE FELIX PHD, LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELIX
Provider First Name:
TAMARA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LMT
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:
1427193259
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5215 NE ELAM YOUNG PKWY
Provider Second Line Business Mailing Address:
A
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97124-6498
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-693-9101
Provider Business Mailing Address Fax Number:
503-693-9123

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5215 NE ELAM YOUNG PKWY
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97124-6498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-693-9101
Provider Business Practice Location Address Fax Number:
503-693-9123
Provider Enumeration Date:
02/20/2007

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: 225700000X , with the licence number:  5352 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP1600X , with the licence number: CERTIFICATION , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 12312003 . This is a "MINISTER PASTORAL COUNSEL" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: MASTER OF SCIENCE . This is a "TRADITIONAL MAYAN MEDICIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00690 . This is a "MEDICAL MASSAGE THERAPIST" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: BACHELOR OF SCIENCE . This is a "TRADITIONAL CHINESE MEDIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: MASTER OF SCIENCE . This is a "CLINICAL HYPNOTHERAPY" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1152 . This is a "CERTIFIED HYPNOTHERAPIST" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: BACHELOR OF SCIENCE . This is a "ANTHROPOLOGY, LITERATURE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 12312003 . This is a "DOCTORATE IN THEOLOGY" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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