| NPI | 1497013296 |
|---|---|
| Other Name | SUSANNE CARLSON, PRESIDENT, PROVIDER, ANNE DRYAD, PROVIDER |
| Entity Type | Organization |
| Authorized Contact | SUSANNE CARLSON President 503-226-1948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 1068) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 1151) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2012-04-30 |