Individual
KELSEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2500 WILLAMETTE FALLS DR STE 207, WEST LINN, OR 97068-4722
(503) 374-2200
Mailing address
3415 SE 74TH AVE APT 20, PORTLAND, OR 97206-2455
(503) 740-2641
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19706
OR
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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