Individual
COLE TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY STE 605, BEAVERTON, OR 97005-3019
(503) 567-4974
Mailing address
2717 SE 15TH AVE, PORTLAND, OR 97202-2205
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25474
OR
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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