Individual provider · Type 1 NPI

Mary Rose Licari

Massage Therapist · Portland, OR

NPI number 1265242945 Active

Practice location

2149 NE Broadway St
Portland, OR 97232-1580

Call (503) 281-0278 Map

Mailing address

2714 SE 138th Ave Apt 55
Portland, OR 97236-2879

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X25550 (OR)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1265242945

Mary Rose Licari's National Provider Identifier is 1265242945, issued on Jan 13, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Jan 13, 2025.