Individual
BETH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5814 SE STARK STREET, PORTLAND, OR 97216
(971) 266-4037
Mailing address
5614 SE STARK STREET, PORTLAND, OR 97216
(203) 213-0856
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21312
OR
Other
Enumeration date
05/08/2015
Last updated
07/19/2018
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