Individual
IRENE TETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
14619 SW TEAL BLVD, BEAVERTON, OR 97007-6194
(503) 746-6585
Mailing address
17185 SW HERITAGE CT, #15, BEAVERTON, OR 97003-5063
(719) 640-6501
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20747
OR
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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