Individual
DEVORA ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2122 NW QUIMBY ST, PORTLAND, OR 97210-2622
(503) 292-7668
Mailing address
6529 SE 58TH AVE, PORTLAND, OR 97206-7511
(850) 499-2108
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23314
OR
Other
Enumeration date
07/30/2017
Last updated
08/09/2017
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