Individual
DEVON EHRENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
18055 SW TV HWY, ALOHA, OR 97003-3953
(503) 642-3018
Mailing address
18055 SW TUALATIN VALLEY HWY, ALOHA, OR 97003-3953
(971) 228-5777
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27002
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-1639099
N/A
OR
Enumeration date
07/14/2022
Last updated
07/14/2022
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