Individual
ANDREA BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
443 NE KNOTT ST, PORTLAND, OR 97212-3108
(503) 941-0152
(503) 282-0464
Mailing address
6948 N MONTANA AVE, PORTLAND, OR 97217-5432
(415) 515-6152
(503) 282-0464
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24741
OR
225700000X
Massage Therapist
29391
CA
Other
Enumeration date
11/20/2013
Last updated
07/09/2019
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