Individual
ANDREA MENDIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2031 SE BELMONT ST, PORTLAND, OR 97214-2812
(971) 325-4234
Mailing address
2031 SE BELMONT ST, PORTLAND, OR 97214-2812
(971) 325-4234
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19676
OR
Other
Enumeration date
04/02/2013
Last updated
09/04/2015
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