Individual
ELIZABETH JANE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
2303 E BURNSIDE ST, PORTLAND, OR 97214-1655
(503) 213-6907
Mailing address
2715 NW SAVIER ST, PORTLAND, OR 97210-2415
(706) 410-0982
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11670
NC
Other
Enumeration date
10/15/2012
Last updated
12/21/2022
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