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Individual

AMANDA JANE ASHLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
407 NW 17TH AVE STE 5, PORTLAND, OR 97209-2247
(971) 221-7154
Mailing address
4927 NE 30TH AVE, PORTLAND, OR 97211-7007
(971) 221-7154

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19392
OR

Other

Enumeration date
07/12/2019
Last updated
07/12/2019
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