Individual
OLIVIA GABRIELLE PIERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CSCS
Contact information
Practice address
905 SE ANKENY ST, PORTLAND, OR 97214-1349
(971) 236-7610
Mailing address
1250 E BURNSIDE ST APT 212, PORTLAND, OR 97214-2269
(858) 414-1394
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
OR24401
OR
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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