Individual
KYLA DAWN MOE-STULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8288 SE 13TH AVE, PORTLAND, OR 97202-6610
(503) 477-9037
Mailing address
5 SE M L KING BLVD APT 1413, PORTLAND, OR 97214-1194
(720) 662-3688
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27336
OR
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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