Individual
MR. WALTER RAYMOND SELENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
500 FOREST AVE., 2ND FLOOR, PORTLAND, ME 04101
(207) 838-4394
(207) 878-3314
Mailing address
500 FOREST AVE, 2ND FLOOR, PORTLAND, ME 04101
(207) 838-4394
(207) 878-3314
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT1104
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100191
ANTHEM BLUE CROSS
ME
Enumeration date
02/28/2007
Last updated
07/24/2012
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