Individual
MS. LUISE WILLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT, NCMT, LMT
Contact information
Practice address
10332 NE OREGON ST, #12, PORTLAND, OR 97220
(720) 877-6926
Mailing address
10332 NE OREGON ST, #12, PORTLAND, OR 97220
(720) 877-6926
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
1362
CO
225700000X
Massage Therapist
Primary
18322
OR
Other
Enumeration date
08/03/2011
Last updated
11/09/2012
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