Organization
MASSAGE FOR HEALING AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY VON BARGEN LMT (OWNER/OPERATOR)
(971) 361-6349
Entity
Organization
Contact information
Practice address
287 NE 3RD ST APT 209, GRESHAM, OR 97030-7722
(971) 361-6349
Mailing address
287 NE 3RD ST APT 209, GRESHAM, OR 97030-7722
(971) 361-6349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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