Individual
KIM MAGRAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3014 NE KILLINGSWORTH ST., PORTLAND, OR 97211
(503) 449-7631
Mailing address
3014 NE KILLINGSWORTH ST., PORTLAND, OR 97211
(503) 449-7631
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19492
OR
225700000X
Massage Therapist
4194
CA
Other
Enumeration date
08/26/2014
Last updated
02/20/2023
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