Organization
MUDRA MASSAGE, LLC
Active
Organization
MUDRA MASSAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY FAILLA LMT (OWNER)
(503) 706-2225
Entity
Organization
Contact information
Practice address
2627 NE BROADWAY ST, PORTLAND, OR 97232-1720
(503) 706-2225
Mailing address
2627 NE BROADWAY ST, PORTLAND, OR 97232-1720
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11600
OR
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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