Individual
MRS. JUDITH IRENE PONTIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4047 N MICHIGAN AVE, PORTLAND, OR 97227-1152
(503) 705-0934
Mailing address
4047 N MICHIGAN AVE, PORTLAND, OR 97227-1152
(503) 705-0934
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10774
OR
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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