Corey Walden, LMT
Individual provider Active NPI Massage Therapist · Beaverton, OR
NPI 1831536473 · NPPES record last updated Nov 18, 2021
Key facts
- NPI
- 1831536473
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 22299 (OR)
- Practice address
- 14355 SW Allen Blvd Ste 120
Beaverton, OR 97005-4700 - Phone
- (503) 730-3038
- NPI assigned
- May 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 22299 | OR | Yes |
Addresses
Primary practice location
14355 SW Allen Blvd Ste 120
Beaverton, OR 97005-4700
Mailing address
14355 SW Allen Blvd Ste 120
Beaverton, OR 97005-4700
Phone (503) 730-3038
Other providers in Beaverton, OR
- Susan E Wagner
- Joshua Wagoner
- Genevieve Chun Hwa Wahl
- Jennifer Monique Wakumelo
- David James Walberg
- Lisa Walden
- Waleed Almulla Dental Services, LLC
- Walgreen Co
- Walgreen Co
- Walgreens
All providers in Beaverton, OR · Massage Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.