Individual
ELIZABETH A MIAKINKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LMP, CA
Contact information
Practice address
16753 NE HALSEY ST, PORTLAND, OR 97230-5666
(503) 804-9711
Mailing address
16753 NE HALSEY ST, PORTLAND, OR 97230-5666
(503) 804-9711
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12878
OR
225700000X
Massage Therapist
MA00022144
WA
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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