Organization
ALTA ULRICH, LMT LLC
Active
Parent organization
884423374
Other names
Alta Massage Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
884423374
Authorized official
ALTA ULRICH LMT (OWNER)
(503) 501-6312
Entity
Organization
Contact information
Practice address
21707 SE STARK ST, GRESHAM, OR 97030-2029
(503) 907-0890
Mailing address
PO BOX 3633, GRESHAM, OR 97030-0398
(503) 907-0890
(833) 638-0790
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/16/2024
Last updated
03/05/2024
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