Individual
KELLY ANNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1971 NW OVERTON ST, ALBA MASSAGE & BODYWORK, PORTLAND, OR 97209-1618
(503) 734-0973
Mailing address
1971 NW OVERTON ST, ALBA MASSAGE & BODYWORK, PORTLAND, OR 97209-1618
(503) 734-0973
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19641
OR
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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