Organization
CHRYSTAL SHAW LMT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRYSTAL SHAW LMT (OWNER)
(503) 381-9876
Entity
Organization
Contact information
Practice address
6200 NE 32ND PL, PORTLAND, OR 97211-6720
(503) 381-9876
Mailing address
6200 NE 32ND PL, PORTLAND, OR 97211-6720
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20397
OR
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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