Individual
CHRISTINE J SIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4342 NE 77TH AVE, PORTLAND, OR 97218-3922
(503) 232-8323
Mailing address
4342 NE 77TH AVE, PORTLAND, OR 97218-3922
(503) 232-8323
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
5980
OR
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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