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Individual

HEATHER MARIE TEACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
606 NE 20TH AVE, PORTLAND, OR 97232-2997
(503) 892-2835
Mailing address
606 NE 20TH AVE, PORTLAND, OR 97232-2997
(503) 892-2835

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
11576
OR

Other

Enumeration date
12/17/2007
Last updated
12/17/2007
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