Ann Marie Southey Butler, LMT
Massage Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1982139648
StatusActive
Last updated in NPPESNov 29, 2023
Details
- NPI
- 1982139648
- Entity type
- Individual (NPI-1)
- Name
- Ann Marie Southey Butler
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 1, 2017
- Last updated
- Nov 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 17700 | OR | Yes |
| 225200000X | Physical Therapy Assistant | 09411 | OR |
Other names
- Ann Marie Mullen (Former Name)
Practice location
2311 E. Burnside StPortland, OR 97214
Phone 503-208-8843
Mailing address
2311 E. Burnside StPortland, OR 97214
Phone 503-208-8843 · Fax 971-319-2195
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