Individual
BREANNA JUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2408 SE 60TH AVE, PORTLAND, OR 97206-1303
(509) 772-1215
Mailing address
2401 SE TAYLOR ST, PORTLAND, OR 97214-2869
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27551
OR
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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