Individual
AUTUMN M SYKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
3117 SE MILWAUKIE AVE, PORTLAND, OR 97202-2427
(503) 236-1200
Mailing address
4409 SE 26TH AVE, PORTLAND, OR 97202-4741
(503) 750-6717
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10954
OR
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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