Individual
EMILIE WYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2188 SW PARK PL, PORTLAND, OR 97205-1100
(707) 738-7351
Mailing address
1916 NE 125TH AVE, PORTLAND, OR 97230-1807
(707) 738-7351
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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