Individual
MOLLIE TINGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2442 SE 101ST AVE STE 205, PORTLAND, OR 97216-3064
(503) 206-5042
Mailing address
6440A NE 32ND PL, PORTLAND, OR 97211-6633
(707) 953-4765
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26624
OR
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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