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Kaitlyn Douglas, LMT

Massage Therapist in Portland, OR. Individual provider (NPI-1).

NPI number1962017459
StatusActive
Last updated in NPPESSep 10, 2020

Details

NPI
1962017459
Entity type
Individual (NPI-1)
Name
Kaitlyn Douglas
Credential
LMT
Sex
Female
Sole proprietor
No
Enumeration date
Sep 10, 2020
Certification date
Sep 10, 2020
Last updated
Sep 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist25073ORYes

Practice location

7817 Se Stark St
Portland, OR 97215-2339

Phone 503-975-5298 · Fax 503-546-7496

Mailing address

3246 Ne 49th Ave
Portland, OR 97213-1849

Phone 971-270-6064

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