Individual
ALEXIS EXTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6504 NE SISKIYOU ST, PORTLAND, OR 97213-4572
(503) 327-3819
Mailing address
1958 NE 72ND AVE, PORTLAND, OR 97213-5358
(707) 543-6955
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23528
OR
225700000X
Massage Therapist
—
—
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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