Individual
KATHRYN SHIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2100 SE LAKE RD, SUITE ONE, MILWAUKIE, OR 97222-7759
(503) 608-9859
Mailing address
7332 SW 13TH DR, APT. C, PORTLAND, OR 97219-2089
(503) 608-9859
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13937
OR
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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