Individual
AMY NICOLE WEDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4425 SW CORBETT AVE, PORTLAND, OR 97239-4260
(503) 225-9033
Mailing address
4930 SW 1ST AVE, PORTLAND, OR 97239-2883
(503) 545-1066
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13880
OR
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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