Individual
KATHRINA LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9204 SE MITCHELL ST, PORTLAND, OR 97266-3831
(503) 777-6746
Mailing address
9204 SE MITCHELL ST, PORTLAND, OR 97266-3831
(503) 777-6746
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21645
OR
Other
Enumeration date
11/21/2019
Last updated
11/27/2023
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