Individual
AMANDA RICKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12741 NE HALSEY ST, PORTLAND, OR 97230-2343
(503) 255-0306
Mailing address
13540 SE 126TH AVE, CLACKAMAS, OR 97015-8602
(971) 806-6457
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27548
OR
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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