Anya Petit, LMT
Massage Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1124887948
StatusActive
Last updated in NPPESMar 14, 2024
Details
- NPI
- 1124887948
- Entity type
- Individual (NPI-1)
- Name
- Anya Petit
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2024
- Certification date
- Mar 14, 2024
- Last updated
- Mar 14, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 28139 | OR | Yes |
Practice location
4933 Ne 16th AvePortland, OR 97211-5041
Phone 617-223-1074
Mailing address
4933 Ne 16th AvePortland, OR 97211-5041
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