Individual
MISS AMANDA J TOMAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
322 NW 5TH AVE, SUITE 308, PORTLAND, OR 97209-3825
(815) 347-1052
Mailing address
1404 SE 36TH AVE, PORTLAND, OR 97214-4241
(815) 347-1052
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22269
OR
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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