Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 11335 | OR |
NPI | 1013349307 |
---|---|
Provider Name | Catherine Oneill |
First Address | Portland, OR 97212-4222 |
Second Address | Portland, OR 97212-4222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2013 |
Last Update Date | 08/08/2013 |