Organization
MASSAGE ENVY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE RENE LAWRENCE LMT (LICENSED MASSAGE THERAPY)
(503) 589-1597
Entity
Organization
Contact information
Practice address
6395 KEIZER STATION BLVD #103, KEIZER, OR 97303-0000
(503) 589-1597
Mailing address
6675 HIDDEN CREEK LOOP NE, KEIZER, OR 97303-7882
(503) 409-1851
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12558
OR
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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