Individual
CRYSTAL LENA PORTHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
23229 LOWER DORRE DON WAY SE, MAPLE VALLEY, WA 98038-8283
(425) 466-4907
Mailing address
23229 LOWER DORRE DON WAY SE, MAPLE VALLEY, WA 98038-8283
(425) 466-4907
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60378587
WA
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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