Individual
MRS. MOLLY GRACE REA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2303 E BURNSIDE ST, PORTLAND, OR 97214-1655
(503) 213-6970
Mailing address
14109 SW ALESCA LN, SHERWOOD, OR 97140-9114
(803) 394-1352
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26795
OR
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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