Individual
LILY ADOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
25603 SE STARK ST, TROUTDALE, OR 97060-3305
(503) 492-6851
Mailing address
25603 SE STARK ST, TROUTDALE, OR 97060-3305
(503) 492-6851
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13198
OR
Other
Enumeration date
06/12/2020
Last updated
06/12/2020
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