Individual
KIMBERLY ANNE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT# 5776
Contact information
Practice address
338 PIONEER WAY, WINCHESTER, OR 97495-8984
(541) 677-0690
(541) 440-0893
Mailing address
PO BOX 159, WINCHESTER, OR 97495-0159
(541) 677-0690
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5776
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5776
MASSAGE THERAPY LICENSE
OR
Enumeration date
01/08/2019
Last updated
01/08/2019
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