Individual
AMANDA GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4927 NE 30TH AVE, PORTLAND, OR 97211-7007
(503) 281-0681
Mailing address
6315 SE 70TH AVE, PORTLAND, OR 97206-6537
(360) 771-5728
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26947
OR
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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