Individual
BLAKE ASHLEY MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CA
Contact information
Practice address
375 W GLOUCESTER ST, GLADSTONE, OR 97027-2036
(360) 270-5890
Mailing address
375 W GLOUCESTER ST, GLADSTONE, OR 97027-2036
(360) 270-5890
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26981
OR
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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