Individual
DANIELLE BOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4922 N VANCOUVER AVE, PORTLAND, OR 97217-2826
(503) 493-9398
Mailing address
4826 NE 38TH AVE, PORTLAND, OR 97211-8121
(406) 334-4307
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28271
OR
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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