Individual
HEATHER R ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1646 SE TENINO ST, PORTLAND, OR 97202-6713
(707) 757-4836
Mailing address
1646 SE TENINO ST, PORTLAND, OR 97202-6713
(707) 757-4836
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25447
OR
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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