Holly Petersen

NPI 1386021137 - Massage Therapist - 225700000X

NPI Details
NPI 1386021137
Gender Female
Enumeration Date 04/30/2015
Last Updated 05/01/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
15081 SE 126TH AVE
CLACKAMAS OR, 97015-9257, US
Phone (503) 419-8337
Fax
Business Location
15081 SE 126TH AVE
CLACKAMAS OR, 97015-9257, US
Phone (503) 419-8337
Fax
Toxanomy
Taxonomy Code 225700000X
License State Oregon
License Number 11496
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According to our database, Holly Petersen NPI is 1386021137, taxonomy code is 225700000X and license number is 11496, license state is located at Oregon. Holly Petersen physically located at 15081 Se 126th Ave, Clackamas OR, 97015-9257. NPI Number Holly Petersen has the Individual type.

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1386021137 NPI number is provided on an as is basis without warranty of any kind. 1386021137 is maintained by the National Plan & Provider Enumeration System. The contents of Holly Petersen are for informational purposes only.