| NPI | 1083971378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLAINE BROOKE FADDIS Licensed Massage Therapist 503-810-4941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR 14317) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |