Organization
KIM LOVELACE, LMT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LOVELACE (LICENSED MASSAGE THERAPIST)
(503) 756-4034
Entity
Organization
Contact information
Practice address
1715 E BURNSIDE ST, PORTLAND, OR 97214-1531
(503) 756-4034
(503) 853-8098
Mailing address
1715 E BURNSIDE ST, PORTLAND, OR 97214-1531
(503) 756-4034
(503) 853-8098
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11751
OR
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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