Individual
JULIA BISNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9260 SE STARK ST, PORTLAND, OR 97216-1675
(240) 672-7678
Mailing address
1340 SE 89TH AVE, PORTLAND, OR 97216-1828
(240) 672-7678
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT21797
OR
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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