Provider Demographics
NPI:1780319277
Name:NORTON, VANESSA (LMT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:NORTON
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 1:158 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-3042
Mailing Address - Country:US
Mailing Address - Phone:503-648-1088
Mailing Address - Fax:503-648-0748
Practice Address - Street 1:158 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3042
Practice Address - Country:US
Practice Address - Phone:503-648-1088
Practice Address - Fax:503-648-0748
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27033225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist