Individual
MELISSA FOUTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10175 SW BARBUR BLVD STE 309B, PORTLAND, OR 97219-5947
(503) 739-3907
Mailing address
10175 SW BARBUR BLVD STE 309B, PORTLAND, OR 97219-5947
(503) 739-3907
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22388
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22388
OREGON MASSAGE THERAPY LICENSE
OR
Enumeration date
10/25/2019
Last updated
10/25/2019
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