Individual
KIM LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1500 NW 18TH AVE, PORTLAND, OR 97209-2557
(971) 227-8316
Mailing address
8155 SW PIUTE CT, TUALATIN, OR 97062-6301
(971) 227-8316
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15294
OR
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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