Individual
MARY ANN FORESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8744 N PENINSULAR AVE, PORTLAND, OR 97217-7072
(512) 870-7443
Mailing address
8744 N PENINSULAR AVE, PORTLAND, OR 97217-7072
(512) 870-7443
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20479
OR
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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