Individual
KELLEY BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
333 NE RUSSELL ST STE 200, PORTLAND, OR 97212-3762
(503) 289-1390
Mailing address
333 NE RUSSELL ST STE 200, PORTLAND, OR 97212-3762
(503) 289-1390
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10223
OR
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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