Individual provider · NPI-1

Ivan Abarzua, LMT

Massage Therapist · Portland, OR

NPI number1194057745
StatusActive
Last updated in NPPESFeb 8, 2010

Details

NPI
1194057745
Entity type
Individual (NPI-1)
Name
Mr. Ivan Abarzua
Credential
LMT
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 8, 2010
Last updated
Feb 8, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist8168ORYes

Practice location

10535 Ne Glisan St
Portland, OR 97220-4077

Phone 503-261-1120

Mailing address

4127 Se Flavel St
Portland, OR 97202-7909

Phone 503-675-1212

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