Provider Demographics
NPI:1427193259
Name:FELIX, TAMARA MARIE (PHD, LMT)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:MARIE
Last Name:FELIX
Suffix:
Gender:F
Credentials:PHD, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5215 NE ELAM YOUNG PKWY
Mailing Address - Street 2:A
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6498
Mailing Address - Country:US
Mailing Address - Phone:503-693-9101
Mailing Address - Fax:503-693-9123
Practice Address - Street 1:5215 NE ELAM YOUNG PKWY
Practice Address - Street 2:A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6498
Practice Address - Country:US
Practice Address - Phone:503-693-9101
Practice Address - Fax:503-693-9123
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5352225700000X
MNCERTIFICATION101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN12312003OtherMINISTER PASTORAL COUNSEL
MASTER OF SCIENCEOtherTRADITIONAL MAYAN MEDICIN
OR00690OtherMEDICAL MASSAGE THERAPIST
BACHELOR OF SCIENCEOtherTRADITIONAL CHINESE MEDIC
ILMASTER OF SCIENCEOtherCLINICAL HYPNOTHERAPY
OR1152OtherCERTIFIED HYPNOTHERAPIST
ORBACHELOR OF SCIENCEOtherANTHROPOLOGY, LITERATURE
MN12312003OtherDOCTORATE IN THEOLOGY
MN12312003OtherMINISTER PASTORAL COUNSEL