Individual
KC DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3863B SW HALL BLVD, BEAVERTON, OR 97005
(503) 626-4242
(503) 626-4242
Mailing address
3863 B SW HALL BLVD, BEAVERTON, OR 97005
(503) 626-4242
(503) 626-4242
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7107
OR
Other
Enumeration date
07/11/2006
Last updated
04/04/2014
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