Individual
TRINITY K SHERADEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2263 NE CORNELL RD, HILLSBORO, OR 97124-5947
(503) 869-7380
(866) 548-6743
Mailing address
1085 MONEDA AVE N, KEIZER, OR 97303-6256
(503) 869-7380
(866) 548-6743
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7300
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7300
MASSAGE LICENSE
OR
01
—
TS1037297
ASHN CREDENTIALLING #
OR
Enumeration date
11/06/2006
Last updated
02/09/2016
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