Individual
MISS ASHLEY MARIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6634 NE ALAMEDA ST, PORTLAND, OR 97213-4657
(360) 980-2761
Mailing address
6634 NE ALAMEDA ST, PORTLAND, OR 97213-4657
(360) 980-2761
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25920
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25920
LICENSED MASSAGE THERAPIST (LMT)
OR
Enumeration date
05/27/2021
Last updated
05/27/2021
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