Individual
STACI CARSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
13403
OR
225700000X
Massage Therapist
Primary
MT11720
SD
Other
Enumeration date
04/16/2008
Last updated
09/06/2023
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