Individual
CHELSEA ELAINE HERETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1507 SE ANKENY ST, PORTLAND, OR 97214-1493
(503) 807-2246
Mailing address
1507 SE ANKENY ST, PORTLAND, OR 97214-1493
(503) 807-2246
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11811
OR
Other
Enumeration date
11/12/2008
Last updated
11/12/2008
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