Individual
KATE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
425 SW MADISON AVE, SUITE W, CORVALLIS, OR 97333-4799
(541) 357-2488
Mailing address
6073 BETHEL LOOP SW, ALBANY, OR 97321-3602
(541) 357-2488
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17952
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
828951
ABMP
OR
Enumeration date
03/14/2011
Last updated
10/10/2011
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