Individual
EDEN D LIEDKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 NW NAITO PKWY APT C4, PORTLAND, OR 97209-3723
(360) 213-9126
Mailing address
710 NW NAITO PKWY APT C4, PORTLAND, OR 97209-3723
(360) 213-9126
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT19564
OR
225700000X
Massage Therapist
MA60530952
WA
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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