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1164040333
ELISA BROCKWAY
LAKE OSWEGO, OR
NPI
1164040333
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 7964)
Enumeration Date
2020-07-14
Last Update Date
2020-07-14
Business Address
ELISA BROCKWAY LMT
530 1ST ST STE B2
LAKE OSWEGO, OR 97034-3248
Phone number: 971-344-4223
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Mailing Address
ELISA BROCKWAY LMT
1605 NE 76TH AVE
PORTLAND, OR 97213-6747
Phone number: 971-344-4223
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