Individual
CALLIE LYNN ROUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12508 NE HALSEY ST, PORTLAND, OR 97230-1929
(503) 860-4175
Mailing address
5598 SE VIEWCREST DR, MILWAUKIE, OR 97267-4145
(503) 860-4175
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12706
OR
Other
Enumeration date
03/25/2007
Last updated
07/08/2007
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