THE GOLDEN ROOM LLC NPI 1205172913

NPI Information

THE GOLDEN ROOM LLC is a specialist in Portland, OR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. THE GOLDEN ROOM LLC NPI is 1205172913. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

636 SE 49TH AVE
PORTLAND, OR
ZIP 97215-728
Phone: (971) 506-4560

The provider's authorized official is Mauri Mckitrick .
The authorized official title is Owner/lmt and has the following contact phone number (971) 506-4560.

The enumeration date for this NPI number is 12/27/2012 and was last updated on 12/27/2012.

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:

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