Individual
KYLIE RENEE BOGETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
5295 NE ELAM YOUNG PKWY STE 150, HILLSBORO, OR 97124-7572
(503) 439-3889
Mailing address
205 NW WALLACE WAY, MCMINNVILLE, OR 97128-5415
(503) 857-0048
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13039
OR
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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