Kelly Forester, LMT
Massage Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1124306352
StatusActive
Last updated in NPPESJun 11, 2014
Details
- NPI
- 1124306352
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kelly Forester
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 21, 2011
- Last updated
- Jun 11, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 10273 | OR | Yes |
Practice location
6018 Se Stark StSte. 103
Portland, OR 97215-1990
Phone 503-754-2696
Mailing address
6018 Se Stark StSte. 103
Portland, OR 97215-1990
Phone 503-754-2696
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