Provider Demographics
NPI:1649983776
Name:ALVAREZ, WENDY P (LMT)
Entity type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:P
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:P
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:2830 NE OVERLOOK DR APT 2236
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7670
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:156 SE 4TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4121
Practice Address - Country:US
Practice Address - Phone:503-681-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116908225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty