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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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