Individual
MADISON WISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5939 SE BELMONT ST UNIT A, PORTLAND, OR 97215-1994
(503) 231-8877
(503) 231-8887
Mailing address
5939 SE BELMONT ST UNIT A, PORTLAND, OR 97215-1994
(503) 231-8877
(503) 231-8887
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24843
OR
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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