Provider Demographics
NPI:1306363890
Name:BATES, AARON LEE (LMT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:LEE
Last Name:BATES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3863 SW HALL BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2042
Mailing Address - Country:US
Mailing Address - Phone:503-446-0698
Mailing Address - Fax:
Practice Address - Street 1:3863 SW HALL BLVD STE B
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2042
Practice Address - Country:US
Practice Address - Phone:503-446-0698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR023581225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist