Organization
MARIE TREVISAN, LLC
Active
Other names
Soma Story OT
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE TREVISAN OT (OWNER)
(208) 882-6736
Entity
Organization
Contact information
Practice address
2833 SE 45TH AVE UNIT B, PORTLAND, OR 97206-1615
(208) 882-6736
Mailing address
2833 SE 45TH AVE UNIT B, PORTLAND, OR 97206-1615
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
11/19/2025
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