Individual
CARDINAL MARKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LMT
Contact information
Practice address
554 SW 12TH CIR, TROUTDALE, OR 97060-4542
(971) 999-3356
Mailing address
554 SW 12TH CIR, TROUTDALE, OR 97060-4542
(719) 993-3569
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25051
OR
Other
Enumeration date
10/24/2022
Last updated
12/16/2024
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