Organization
MAMAHAVEN MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE TEGTMEIER LMT (OWNER)
(860) 922-6439
Entity
Organization
Contact information
Practice address
6536 SE DUKE ST, PORTLAND, OR 97206-6665
(860) 922-6439
Mailing address
12349 SE KNAPP ST, PORTLAND, OR 97236-5017
(860) 922-6439
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18614
OR
Other
Enumeration date
03/27/2013
Last updated
03/27/2013
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