Provider Demographics
NPI:1942733522
Name:ARENDT, VIRGINIA (LMT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:ARENDT
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 1:19355 SW 65TH AVE
Mailing Address - Street 2:APT 157
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9247
Mailing Address - Country:US
Mailing Address - Phone:503-270-1185
Mailing Address - Fax:
Practice Address - Street 1:16315 SW BARROWS RD
Practice Address - Street 2:203A
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-9461
Practice Address - Country:US
Practice Address - Phone:503-746-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19807172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist