Provider Demographics
NPI:1750624698
Name:PIROZZI, TARIA ANN (LMT)
Entity type:Individual
Prefix:
First Name:TARIA
Middle Name:ANN
Last Name:PIROZZI
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 1:10175 SW TRAPPER TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7814
Mailing Address - Country:US
Mailing Address - Phone:503-933-3495
Mailing Address - Fax:
Practice Address - Street 1:7110 SW FIR LOOP
Practice Address - Street 2:SUITE 210
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8084
Practice Address - Country:US
Practice Address - Phone:503-639-2243
Practice Address - Fax:503-746-7432
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13654171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR13654OtherOREGON MASSAGE LICENSE