Individual
HEATHER LEEANN BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
7155 SW VARNS ST, SUITE 110, TIGARD, OR 97223-8174
(971) 599-3603
Mailing address
3603 SE GRANT CT, PORTLAND, OR 97214-5837
(503) 998-8973
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21588
OR
Other
Enumeration date
11/13/2015
Last updated
05/15/2016
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