Individual
MS. MOLLY PEARL OWEN PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
818 NW 17TH AVE, SUITE 6, PORTLAND, OR 97209
(651) 307-2444
Mailing address
818 NW 17TH AVE, SUITE 6, PORTLAND, OR 97209
(651) 307-2444
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18158
OR
Other
Enumeration date
06/25/2012
Last updated
10/24/2017
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