Individual
MRS. MELISSA ANNE KETRENOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
9045 SW BARBUR BLVD, SUITE 107, PORTLAND, OR 97219-4021
(503) 679-9719
Mailing address
9045 SW BARBUR BLVD, SUITE 107, PORTLAND, OR 97219-4021
(503) 679-9719
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
15460
OR
174400000X
Specialist
Primary
15460
OR
Other
Enumeration date
01/04/2010
Last updated
01/04/2010
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