Individual
GWENDOLYN SHEARER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10600 SE MCLOUGHLIN BLVD, SUITE 206, MILWAUKIE, OR 97222-7428
(503) 887-4693
Mailing address
PO BOX 6, ESTACADA, OR 97023-0006
(503) 887-4693
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10150
OR
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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