Provider Demographics
NPI:1508150806
Name:GIUSTO, ERIN PAGE (LMT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:PAGE
Last Name:GIUSTO
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 1:24375 SE STRAWBERRY DR
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-7364
Mailing Address - Country:US
Mailing Address - Phone:503-710-8517
Mailing Address - Fax:
Practice Address - Street 1:24375 SE STRAWBERRY DR
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:OR
Practice Address - Zip Code:97089-7364
Practice Address - Country:US
Practice Address - Phone:503-710-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6938172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist