Individual
ELIZABETH O'MALLEY-WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2207 NE BROADWAY ST, PORTLAND, OR 97232-1693
(503) 575-6318
Mailing address
2207 NE BROADWAY ST, PORTLAND, OR 97232-1693
(503) 575-6318
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19005
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19005
LMT
OR
Enumeration date
12/26/2012
Last updated
03/08/2013
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