Provider Demographics
NPI:1275379513
Name:COX, MAREN (LMT)
Entity type:Individual
Prefix:
First Name:MAREN
Middle Name:
Last Name:COX
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 1:3130 MOORELAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-2993
Mailing Address - Country:US
Mailing Address - Phone:801-386-3676
Mailing Address - Fax:
Practice Address - Street 1:2150 COMMERCIAL ST SE STE 10
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5379
Practice Address - Country:US
Practice Address - Phone:971-707-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28398225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist