Provider Demographics
NPI:1902178064
Name:DEMARIS, NAVA ROXANNE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:NAVA
Middle Name:ROXANNE
Last Name:DEMARIS
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 1:19401 S RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8681
Mailing Address - Country:US
Mailing Address - Phone:503-507-8657
Mailing Address - Fax:503-882-5814
Practice Address - Street 1:19401 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8681
Practice Address - Country:US
Practice Address - Phone:503-507-8657
Practice Address - Fax:503-882-5814
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15184173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist