Individual
AMY JOHANNA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2177 SW MAIN ST, PORTLAND, OR 97205-1123
(503) 989-2766
Mailing address
2177 SW MAIN ST, PORTLAND, OR 97205-1123
(503) 989-2766
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6386
OR
Other
Enumeration date
09/16/2013
Last updated
04/09/2024
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