Provider Demographics
NPI:1831389600
Name:TUPPER, UMA DAWN OSHA (LAC, LMT)
Entity type:Individual
Prefix:
First Name:UMA
Middle Name:DAWN OSHA
Last Name:TUPPER
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 NW DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3103
Mailing Address - Country:US
Mailing Address - Phone:503-525-9642
Mailing Address - Fax:
Practice Address - Street 1:925 NW DAVIS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3103
Practice Address - Country:US
Practice Address - Phone:503-525-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01052171100000X
OR6686225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist