Provider Demographics
NPI:1760922520
Name:POWER, CHELSEA (LMT)
Entity Type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:
Last Name:POWER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:DAWN
Other - Last Name:POWER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:7771 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4613
Mailing Address - Country:US
Mailing Address - Phone:503-333-3653
Mailing Address - Fax:
Practice Address - Street 1:7771 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4613
Practice Address - Country:US
Practice Address - Phone:503-333-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19894225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist