Individual
ALYSSA ACKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 SE 12TH AVE, PORTLAND, OR 97214-2513
(503) 482-9253
Mailing address
15602 SE MADISON CT, PORTLAND, OR 97233-3654
(517) 927-6735
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25025
OR
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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