Individual
MR. MICHAEL E KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
9123 SE SAINT HELENS ST STE 100A, CLACKAMAS, OR 97015-6800
(503) 482-2122
Mailing address
9123 SE SAINT HELENS ST STE 100A, CLACKAMAS, OR 97015-6800
(503) 482-2122
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20117
OR
Other
Enumeration date
07/07/2019
Last updated
07/07/2019
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