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Organization
PORTLAND BODYWORK
Active
Organization
PORTLAND BODYWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BLATT LMT (LICENSED MASSAGE THERAPIST)
(503) 407-4827
Entity
Organization
Contact information
Practice address
2450 SE BELMONT ST, PORTLAND, OR 97214-2821
(503) 407-4827
Mailing address
1539 SE BELMONT ST, PORTLAND, OR 97214-2641
(503) 407-4827
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21264
OR
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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