Individual
BETH SCHOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5336 SE BUSH ST, PORTLAND, OR 97206-5394
(503) 502-5115
Mailing address
4404 NE 74TH AVE, PORTLAND, OR 97218-3639
(503) 502-5115
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11598
OR
Other
Enumeration date
03/03/2009
Last updated
10/08/2009
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