Individual
ELISA A STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
4838 NE SANDY BLVD, STE. #200, PORTLAND, OR 97213-2091
(503) 287-1510
Mailing address
4325 NE HALSEY ST, APT. #17, PORTLAND, OR 97213-1556
(503) 810-5318
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10210
OR
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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