Individual
ANDREA HALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1416 SE 8TH AVE, SUITE 100, PORTLAND, OR 97214-3537
(503) 239-5125
Mailing address
1416 SE 8TH AVE, SUITE 100, PORTLAND, OR 97214-3537
(949) 350-3310
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20578
OR
Other
Enumeration date
05/02/2014
Last updated
10/21/2016
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