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Individual

SYDNEY LYND FOLTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1330 SE 39TH AVE, PORTLAND, OR 97214-4322
(503) 232-1200
Mailing address
1958 SE 27TH AVE, LOWER UNIT, PORTLAND, OR 97214-4963
(971) 285-3196

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12948
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12948
OREGON MASSAGE LICENSE
OR
01
MA00019521
WA MASSAGE LICENSE
WA
Enumeration date
10/05/2006
Last updated
07/08/2007
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