Individual
ELAINE LOUISE GAETANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4922 N VANCOUVER AVE, PORTLAND, OR 97217-2826
(503) 493-9398
Mailing address
5615 N MARYLAND AVE, PORTLAND, OR 97217-4628
(408) 310-7072
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21815
OR
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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