Individual
MRS. HEIDI LEONARD SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5295 NE ELAM YOUNG PKWY, SUITE 150, HILLSBORO, OR 97124-7567
(503) 530-8517
Mailing address
241 NW DENNIS AVE, HILLSBORO, OR 97124-2916
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10994
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10994
OREGON MASSAGE THERAPY LICENSE
OR
Enumeration date
06/09/2010
Last updated
06/09/2010
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