Individual
MS. KELLY FORESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6018 SE STARK ST, STE. 103, PORTLAND, OR 97215-1990
(503) 754-2696
Mailing address
6018 SE STARK ST, STE. 103, PORTLAND, OR 97215-1990
(503) 754-2696
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10273
OR
Other
Enumeration date
07/21/2011
Last updated
06/11/2014
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