Provider Demographics
NPI:1992359087
Name:SOLAITA, ELINA LYNAE (RN, MBA, CCM, LMT)
Entity Type:Individual
Prefix:
First Name:ELINA
Middle Name:LYNAE
Last Name:SOLAITA
Suffix:
Gender:F
Credentials:RN, MBA, CCM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MOLALLA AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2627
Mailing Address - Country:US
Mailing Address - Phone:503-451-0212
Mailing Address - Fax:
Practice Address - Street 1:151 MOLALLA AVE
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2627
Practice Address - Country:US
Practice Address - Phone:503-451-0212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24965225700000X
OR200641641RN163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist