Individual
GRACE KERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
2024 SE CLINTON ST, PORTLAND, OR 97202-2245
(503) 238-6262
Mailing address
5619 SE BELMONT ST, PORTLAND, OR 97215-1841
(503) 235-2388
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5587
OR
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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