Provider Demographics
NPI:1023806569
Name:NAVARRO, SOLEIL (LMT)
Entity type:Individual
Prefix:
First Name:SOLEIL
Middle Name:
Last Name:NAVARRO
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 1:3039 NE HALE AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3358
Mailing Address - Country:US
Mailing Address - Phone:503-225-9033
Mailing Address - Fax:
Practice Address - Street 1:4425 S CORBETT AVE UPPR LEVEL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4287
Practice Address - Country:US
Practice Address - Phone:503-225-9033
Practice Address - Fax:503-225-9039
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLMT-27037225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist