Velma Marie Amaya-Medina

Individual provider Active NPI Massage Therapist · Wilsonville, OR

NPI 1730550344 · NPPES record last updated Oct 8, 2015

Key facts

NPI
1730550344
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
16897 (OR)
Practice address
8695 SW Jack Burns Blvd Ste E
Wilsonville, OR 97070-5797
Phone
(503) 427-2698
NPI assigned
Oct 8, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
16897ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Suke Enterprises, Inc. Massage Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 16897 OR Yes

Addresses

Primary practice location

8695 SW Jack Burns Blvd Ste E
Wilsonville, OR 97070-5797

Mailing address

8695 SW Jack Burns Blvd Ste E
Wilsonville, OR 97070-5797
Phone (503) 427-2698

Other providers in Wilsonville, OR

All providers in Wilsonville, OR · Massage Therapist in Oregon

Sources for this page

Verify at the official NPI Registry.