Individual
ANGELICA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
635 SE 70TH AVE, PORTLAND, OR 97215-2125
(503) 467-9584
Mailing address
635 SE 70TH AVE, PORTLAND, OR 97215-2125
(503) 467-9584
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17698
OR
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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