Individual
IRIS M WATERLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2609 N WILLIS BLVD, PORTLAND, OR 97217-7039
(503) 740-6963
Mailing address
2609 N WILLIS BLVD, PORTLAND, OR 97217-7039
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21190
OR
Other
Enumeration date
03/03/2017
Last updated
09/29/2023
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