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Individual

MS. ANGELA ILENE HOLMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
2641 SW HUBER ST, PORTLAND, OR 97219-6338
(503) 891-6769
Mailing address
2641 SW HUBER ST, PORTLAND, OR 97219-6338
(503) 891-6769

Taxonomy

Speciality
Code
Description
License number
State
225600000X
Dance Therapist
NIA WHITE BELT
OR
225700000X
Massage Therapist
Primary
11246
OR

Other

Enumeration date
05/07/2008
Last updated
05/07/2008
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