Individual
MADELINE LESLIE CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3863 SW HALL BLVD, STE B, BEAVERTON, OR 97005-2042
(541) 944-1989
Mailing address
1517 SE OAK ST, PORTLAND, OR 97214-1454
(541) 944-1989
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20033
OR
Other
Enumeration date
04/07/2014
Last updated
04/07/2014
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