Individual
ALISSA K KIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
123 NE 6TH AVE, PORTLAND, OR 97232-2903
(503) 961-4036
Mailing address
123 NE 6TH AVE, PORTLAND, OR 97232-2903
(503) 961-4036
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18918
OR
Other
Enumeration date
04/07/2017
Last updated
04/10/2017
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