Individual
MISS CARA REBECCA ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4512 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6274
(503) 777-2776
Mailing address
PO BOX 8469, PORTLAND, OR 97207
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225700000X
Massage Therapist
18093
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
QMHA
OR
01
—
18093
LICENSED MASSAGE THERAPIST
OR
Enumeration date
03/01/2007
Last updated
03/21/2013
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