Individual
COEISHA WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7401 N ALBINA AVE, PORTLAND, OR 97217-1300
(503) 330-9476
Mailing address
5100 NE 46TH ST, VANCOUVER, WA 98661-2831
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25630
OR
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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