Individual
MRS. LACEY KATHLEEN ABBOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
24595 SE STARK ST, TROUTDALE, OR 97060-3390
(503) 492-6851
Mailing address
24595 SE STARK ST, TROUTDALE, OR 97060-3390
(503) 492-6851
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10606
OR
Other
Enumeration date
10/20/2009
Last updated
11/14/2013
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