Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gina Marie Callaway, LMT17789

Individual provider Specialist · NPI 1053616441

Gina Marie Callaway, LMT17789 is a Specialist in Tigard, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2011
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Practice location Address checks out

11501 SW Pacific Hwy Ste 100
Tigard, OR 97223-8649
Phone: (503) 862-7787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence LMT 17789 (OR)

Record details

NPI number1053616441
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMT17789
Sole proprietorYes
NPI enumeratedJanuary 17, 2011
Last updated in NPPESJanuary 30, 2024
Certification dateJanuary 30, 2024

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