Organization
MASSOTHERAPY CLINIC, PC
Active
Other names
Susanne Carlson, president, provider, Anne Dryad, provider
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE CARLSON MS, LMT (PRESIDENT)
(503) 226-1948
Entity
Organization
Contact information
Practice address
1220 SW MORRISON SUITE 410, PORTLAND, OR 97205
(503) 226-1948
(503) 226-1598
Mailing address
1220 SW MORRISON SUITE 410, PORTLAND, OR 97205
(503) 226-1948
(503) 226-1598
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1068
OR
225700000X
Massage Therapist
1151
OR
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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