Individual
NEVRA UCAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
17580 NW SPRINGVILLE RD UNIT G20, PORTLAND, OR 97229-1868
(971) 330-4191
Mailing address
17580 NW SPRINGVILLE RD UNIT G20, PORTLAND, OR 97229-1868
(971) 330-4191
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26475
OR
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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