NPI | 1255750659 |
---|---|
Former Legal Business Name | SHERI BLUE, LMT |
Entity Type | Organization |
Authorized Contact | SHERI BLUE Owner 503-367-4274 |
Organization Subpart ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 5842) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 11-12-06) |
1041C0700X Social Worker Clinical (Licence: OR L6079) | |
Enumeration Date | 2014-04-14 |
Last Update Date | 2014-04-14 |