Organization
FOOT BAR BODY BAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER PITTMAN LMT (OWNER)
(503) 575-4891
Entity
Organization
Contact information
Practice address
908 NW 14TH AVE, PORTLAND, OR 97209-2704
(503) 575-4891
Mailing address
3012 SE FRANKLIN ST, PORTLAND, OR 97202-1929
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7949
OR
Other
Enumeration date
12/29/2010
Last updated
09/15/2011
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