Individual
MRS. ADAH GRACE LAVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1030 NW MARSHALL ST, PORTLAND, OR 97209
(503) 227-2279
Mailing address
1030 NW MARSHALL ST, PORTLAND, OR 97209-2988
(503) 227-2279
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24199
OR
372600000X
Adult Companion
—
—
Other
Enumeration date
09/10/2012
Last updated
07/25/2018
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