Organization
MERIDIAN MEDICAL MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADDY CHAVEZ LMT (OWNER)
(503) 446-0698
Entity
Organization
Contact information
Practice address
3863 SW HALL BLVD, SUITE B, BEAVERTON, OR 97005-2042
(541) 944-1989
Mailing address
3863 SW HALL BLVD, SUITE B, BEAVERTON, OR 97005-2042
(541) 944-1989
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20033
OR
Other
Enumeration date
04/06/2016
Last updated
08/17/2016
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