Doctor Name: | ELIZA WERTH-DAVIS |
NPI Number: | 1689087041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 20653 |
Business Practice Address: | 16083 Sw Upper Boones Ferry Rd Ste 300 Tigard, OR - 972247736 |
Business Phone Number: | 8002198835 |
Business Fax Number: | 5036399699 |
Mailing Address: | 17355 Boones Ferry Rd, Suite B LAKE OSWEGO |
State: | OR |
Postal Code: | 970355202 |
Phone Number: | 5036350844 |
Fax Number: | |
NPI Enumeration Date: | 06/03/2014 |
NPI Last Update Date: | 10/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 20653 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |