Individual
HEATHER GRACE GORDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3204 S KELLY AVE, PORTLAND, OR 97239-4626
(646) 255-3770
Mailing address
3204 S KELLY AVE, PORTLAND, OR 97239-4626
(646) 255-3770
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29120
OR
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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