Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 20093 | OR |
NPI | 1003243676 |
---|---|
Provider Name | Ms. Melissa Rebecca Yoast |
First Address | Clackamas, OR 97015-0561 |
Second Address | Happy Valley, OR 97086-6091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2013 |
Last Update Date | 26/02/2016 |