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1043775190
AMANDA GANGSTEAD
PORTLAND, OR
NPI
1043775190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 18143)
Enumeration Date
2019-02-03
Last Update Date
2019-02-03
Business Address
AMANDA GANGSTEAD
13306 NW CORNELL RD STE 207
PORTLAND, OR 97229-5806
Phone number: 541-749-0818
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Mailing Address
AMANDA GANGSTEAD
16312 SW ESTUARY DR APT 203
BEAVERTON, OR 97006-7936
Phone number: 541-749-0818
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