Organization
MUSCLE AND MOVEMENT THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONA LEE MATTHEWS LMT (LMT)
(208) 940-2053
Entity
Organization
Contact information
Practice address
5940 SE 138TH PL, PORTLAND, OR 97236-4402
(208) 940-2053
Mailing address
5940 SE 138TH PL, PORTLAND, OR 97236-4402
(208) 940-2053
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
19679
OR
Other
Enumeration date
07/26/2014
Last updated
07/26/2014
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