Elisa Brockway, LMT
Massage Therapist in Lake Oswego, OR. Individual provider (NPI-1).
NPI number1164040333
StatusActive
Last updated in NPPESJul 14, 2020
Details
- NPI
- 1164040333
- Entity type
- Individual (NPI-1)
- Name
- Elisa Brockway
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 14, 2020
- Certification date
- Jul 14, 2020
- Last updated
- Jul 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 7964 | OR | Yes |
Practice location
530 1st St Ste B2Lake Oswego, OR 97034-3248
Phone 971-344-4223
Mailing address
1605 Ne 76th AvePortland, OR 97213-6747
Phone 971-344-4223
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All 154 Massage Therapist providers in Lake Oswego · All 1,781 providers in Lake Oswego
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