Colleen Alicia Smith LMT

NPI 1578861175 - Massage Therapist - 225700000X

NPI Details
NPI 1578861175
Gender Female
Enumeration Date 03/05/2011
Last Updated 03/05/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
430 SW 13TH AVE
PORTLAND OR, 97205-2361, US
Phone (503) 544-8726
Fax
Business Location
430 SW 13TH AVE
PORTLAND OR, 97205-2361, US
Phone (503) 544-8726
Fax
Toxanomy
Taxonomy Code 225700000X
License State Oregon
License Number 16502
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According to our database, Colleen Alicia Smith LMT NPI is 1578861175, taxonomy code is 225700000X and license number is 16502, license state is located at Oregon. Colleen Alicia Smith LMT physically located at 430 Sw 13th Ave, Portland OR, 97205-2361. NPI Number Colleen Alicia Smith LMT has the Individual type.

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1578861175 NPI number is provided on an as is basis without warranty of any kind. 1578861175 is maintained by the National Plan & Provider Enumeration System. The contents of Colleen Alicia Smith LMT are for informational purposes only.