Individual
GWENDOLYN JOY KOCHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030-5770
(503) 665-8959
Mailing address
21691 S WISTERIA RD, WEST LINN, OR 97068-7228
(971) 212-6847
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6149
OR
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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