Individual
MISS KRYSTLE M CLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10303 NE WEIDLER ST, PORTLAND, OR 97220-3882
(503) 255-0306
Mailing address
10303 NE WEIDLER ST, PORTLAND, OR 97220-3882
(503) 255-0306
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13307
OR
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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