Provider Demographics
NPI:1316211147
Name:PARTIDA, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PARTIDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 RAMSGATE SQ S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5864
Mailing Address - Country:US
Mailing Address - Phone:503-868-1723
Mailing Address - Fax:503-961-1956
Practice Address - Street 1:180 RAMSGATE SQ S # 3
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5864
Practice Address - Country:US
Practice Address - Phone:503-868-1723
Practice Address - Fax:503-961-1956
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18789225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist