Individual
MS. KATHRYN JOAN OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3737 N MISSISSIPPI AVE, PORTLAND, OR 97227-1158
(503) 467-4511
(503) 467-4513
Mailing address
3737 N MISSISSIPPI AVE, PORTLAND, OR 97227-1158
(503) 467-4511
(503) 467-4513
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15550
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15550
LMT
OR
Enumeration date
04/22/2009
Last updated
04/22/2009
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