Individual
KELSEY BOSTWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3430 SE BELMONT ST, PORTLAND, OR 97214-4247
(503) 936-0104
Mailing address
5125 NE CLEVELAND AVE, PORTLAND, OR 97211-2611
(503) 936-0104
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22713
OR
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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