Individual
HEATHER YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
419 NW 23RD AVE, PORTLAND, OR 97210-3470
(415) 410-4622
Mailing address
11640 SW BOONES FERRY RD, PORTLAND, OR 97219-7736
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
19977
OR
172M00000X
Mechanotherapist
33014
CA
225700000X
Massage Therapist
Primary
19977
OR
225700000X
Massage Therapist
33014
CA
Other
Enumeration date
10/16/2015
Last updated
12/22/2015
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