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Organization
RESTORE MASSAGE THERAPY, INC
Active
Organization
RESTORE MASSAGE THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA GRACE APODACA LMT (OWNER/ MASSAGE THERAPIST)
(503) 701-7714
Entity
Organization
Contact information
Practice address
1922 21ST AVE, FOREST GROVE, OR 97116-1638
(503) 701-7714
Mailing address
1922 21ST AVE, FOREST GROVE, OR 97116-1638
(503) 701-7714
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11539
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
MASSAGE THERAPIST
OR
Enumeration date
10/07/2014
Last updated
10/07/2014
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