Organization
BODY ALTAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA BLUM LMT (OWNER)
(415) 515-6152
Entity
Organization
Contact information
Practice address
443 NE KNOTT ST, PORTLAND, OR 97212-3108
(503) 941-0152
(503) 282-1070
Mailing address
6948 N MONTANA AVE, PORTLAND, OR 97217-5432
(415) 515-6152
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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