Individual
JULIA KHVASECHKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1304 SE ASH ST, UNIT A, PORTLAND, OR 97214-6402
(917) 573-3370
Mailing address
1304 SE ASH ST, UNIT A, PORTLAND, OR 97214-6402
(917) 573-3370
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22606
OR
Other
Enumeration date
09/02/2016
Last updated
09/15/2016
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