Organization
ELEMENTS THERAPEUTIC MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS MCMILLIN (OWNER)
(503) 722-8888
Entity
Organization
Contact information
Practice address
22000 WILLAMETTE DR, 107, WEST LINN, OR 97068-3275
(503) 722-8888
Mailing address
22000 WILLAMETTE DR, 107, WEST LINN, OR 97068-3275
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4029
OR
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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