| NPI | 1639438419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE CAROLE MODESITT Licensed Massage Therapist 503-699-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR 1045) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |