Organization
EMBODIMENT EVOLUTION, LLC
Active
Other names
Eric Van Leeuwen, LMT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC VAN LEEUWEN LMT (MASSAGE THERAPIST)
(415) 609-4343
Entity
Organization
Contact information
Practice address
2403 SE MONROE ST STE B, MILWAUKIE, OR 97222-7646
(503) 303-4078
Mailing address
1414 SE LONG ST, PORTLAND, OR 97202-5030
(415) 609-4343
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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