Individual
KRISTA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
289 E ELLENDALE AVE STE 601, DALLAS, OR 97338-1570
(503) 751-1460
(503) 623-2268
Mailing address
289 E. ELLENDALE AVE. SUITE 601, DALLAS, OR 97338
(503) 751-1460
(503) 623-2268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18490
OR
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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