Individual
MARY ELIZABETH EVERITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1990 SE LADD AVE, PORTLAND, OR 97214-4757
(503) 820-8040
Mailing address
710 SE 29TH AVE, PORTLAND, OR 97214-3028
(503) 924-9667
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21480
OR
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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