Individual
SHANNON ELIZABETH BALUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5924 ANAHEIM AVE NE STE B, ALBUQUERQUE, NM 87113-1879
(505) 881-4618
(505) 922-4917
Mailing address
628 NE ROSELAWN ST, PORTLAND, OR 97211-3830
(323) 371-4829
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
19720
OR
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/13/2013
Last updated
04/28/2025
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