Individual
CARRIE RENE GEROLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3401 SE 192ND AVE STE 107, VANCOUVER, WA 98683-1472
(360) 882-7733
Mailing address
1221 NE 51ST AVE APT 363, HILLSBORO, OR 97124-6192
(702) 238-3090
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
22827
OR
225700000X
Massage Therapist
Primary
60691675
WA
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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