Organization
AMY OLDENDORF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY OLDENDORF (MASSAGE THERAPIST)
(518) 928-4098
Entity
Organization
Contact information
Practice address
4927 NE 30TH AVE, PORTLAND, OR 97211-7007
(503) 281-0681
Mailing address
4803 NE 30TH AVE, PORTLAND, OR 97211-7005
(518) 928-4098
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16138
OR
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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