Individual
AMELIA DUBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
107 SE WASHINGTON ST, PORTLAND, OR 97214-2103
(503) 236-6633
Mailing address
2370 SE 53RD AVE, PORTLAND, OR 97215-3918
(503) 758-0654
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17776
OR
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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