Provider Demographics
NPI:1942035423
Name:BOWEN, CAMILLE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:MARIE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:MARIE
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14845 SW MURRAY SCHOLLS DRIVE
Mailing Address - Street 2:SUITE 110 PMB 617
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007
Mailing Address - Country:US
Mailing Address - Phone:503-866-4905
Mailing Address - Fax:
Practice Address - Street 1:21370 SW LANGER FARMS PKWY STE 138
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9140
Practice Address - Country:US
Practice Address - Phone:503-625-6247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17111225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist