Provider Demographics
NPI:1033581988
Name:MONTES, TRISHA ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANNE
Last Name:MONTES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13370 NW MASON HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-8001
Mailing Address - Country:US
Mailing Address - Phone:503-926-4486
Mailing Address - Fax:
Practice Address - Street 1:13370 NW MASON HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH PLAINS
Practice Address - State:OR
Practice Address - Zip Code:97133
Practice Address - Country:US
Practice Address - Phone:503-926-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20651225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist