Individual
ELIZABETH SUSAN BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1881 SW NAITO PKWY, PORTLAND, OR 97210-5195
(503) 830-5906
Mailing address
7806 NE HOLLADAY ST, PORTLAND, OR 97213-6847
(503) 830-5906
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8037
OR
Other
Enumeration date
12/24/2009
Last updated
12/24/2009
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