Organization
RESTORE MASSAGE PDX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY N REAGAN (LICENSED MASSAGE THERAPIST)
(971) 570-1495
Entity
Organization
Contact information
Practice address
14833 SW 72ND AVE, TIGARD, OR 97224-7911
(971) 570-1495
Mailing address
14833 SW 72ND AVE, TIGARD, OR 97224-7911
(971) 570-1495
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
17822
OR
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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