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1104332006
KELLY ANN STARK
HILLSBORO, OR
NPI
1104332006
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 11440)
Enumeration Date
2017-12-15
Last Update Date
2017-12-15
Business Address
KELLY ANN STARK
2167 NW 185TH AVE
HILLSBORO, OR 97124-7074
Phone number: 503-336-3456
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Mailing Address
KELLY ANN STARK
1612 NE PARKSIDE DR
HILLSBORO, OR 97124-3925
Phone number: 503-857-9504
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