Martha Ann Damato, LMT

Individual provider Active NPI Contractor · Tigard, OR

NPI 1659606846 · NPPES record last updated Oct 6, 2009

Key facts

NPI
1659606846
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
9161 (OR)
Practice address
10500 SW Greenburg Rd
Tigard, OR 97223-1406
Phone
(503) 684-9698
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9161ORMDContractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 9161 OR Yes

Addresses

Primary practice location

10500 SW Greenburg Rd
Tigard, OR 97223-1406

Mailing address

22210 SW Murdock Rd
Apt a-3
Sherwood, OR 97140-9764
Phone (541) 914-2984

Other providers in Tigard, OR

All providers in Tigard, OR · Contractor in Oregon

Sources for this page

Verify at the official NPI Registry.