Individual provider · NPI-1

Alyssa Ackerman

Massage Therapist · Portland, OR

NPI number1528622347
StatusActive
Last updated in NPPESApr 26, 2019

Details

NPI
1528622347
Entity type
Individual (NPI-1)
Name
Alyssa Ackerman
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 26, 2019
Last updated
Apr 26, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist25025ORYes

Practice location

1016 Se 12th Ave
Portland, OR 97214-2513

Phone 503-482-9253

Mailing address

15602 Se Madison Ct
Portland, OR 97233-3654

Phone 517-927-6735

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Massage Therapist providers in Portland, OR