Individual
CHRYSTAL SHAW BOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
519 SW PARK AVE, SUITE 306, PORTLAND, OR 97205-3221
(503) 381-9876
Mailing address
519 SW PARK AVE STE 306, PORTLAND, OR 97205-3204
(503) 381-9876
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20397
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20397
LICENSED MASSAGE THERAPIST
OR
Enumeration date
09/09/2014
Last updated
08/10/2016
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