Individual
KATIE MAELOUISE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4150 PACIFIC AVE STE 100, FOREST GROVE, OR 97116-2786
(503) 866-8782
Mailing address
4150 PACIFIC AVE STE 100, FOREST GROVE, OR 97116-2786
(503) 866-8782
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-21736
OR
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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