SOPHIE CAROLINE GRACE PANDER LMT; ESTHETICIAN NPI 1528527850

NPI Information

NPI: 1528527850
Provider Name: SOPHIE CAROLINE GRACE PANDER, LMT; ESTHETICIAN
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
210 NW 17TH AVE
PORTLAND, OR
ZIP 97209
Phone: (971) 407-3066
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Sophie Caroline Grace Pander, LMT; ESTHETICIAN is a massage therapist in Portland, OR. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Sophie Caroline Grace Pander, LMT; ESTHETICIAN NPI is 1528527850. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

210 NW 17TH AVE
PORTLAND, OR
ZIP 97209-151
Phone: (971) 407-3066

The enumeration date for this NPI number is 3/16/2019 and was last updated on 3/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		6457	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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