Individual
LESLIE VILLELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, HHP
Contact information
Practice address
2534 NW VAUGHN ST, PORTLAND, OR 97210-2552
(503) 477-8881
(503) 719-4695
Mailing address
4975 SW LOMBARD AVE, BEAVERTON, OR 97005-2936
(760) 672-0033
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15218
OR
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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