Individual
MS. ELIZA LYNN CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3800 SW CEDAR HILLS BLVD, STE 193, BEAVERTON, OR 97005-2027
(503) 643-3827
Mailing address
4200 SW 107TH AVE, APT 3402, BEAVERTON, OR 97005-3177
(503) 336-0866
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6683
OR
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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