Organization
MOVEO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ROSE BERRY LMT (OWNER/LMT)
(503) 475-8722
Entity
Organization
Contact information
Practice address
200 NE 20TH AVE STE 20, PORTLAND, OR 97232-3094
(503) 475-8722
Mailing address
1718 NE SUMNER ST, PORTLAND, OR 97211-5637
(503) 475-8722
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16467
OR
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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