Individual
MARTHA J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
163 NE 102ND AVE, BUILDING V, PORTLAND, OR 97220-4169
(503) 257-3327
Mailing address
163 NE 102ND AVE, BUILDING V, PORTLAND, OR 97220-4169
(503) 257-3327
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15365
OR
Other
Enumeration date
10/12/2009
Last updated
10/12/2009
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