Individual
BLAKE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23500 SE STARK ST, GRESHAM, OR 97030-2942
(503) 406-8846
Mailing address
23500 SE STARK ST, GRESHAM, OR 97030-2942
(503) 406-8846
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24304
OR
Other
Enumeration date
05/06/2024
Last updated
03/26/2026
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