Individual provider · Type 1 NPI

Chung So, LMT(OREGON #4132)

Massage Therapist · Portland, OR

NPI number 1003172412 Active

Practice location

1616 SE Bybee Blvd
Portland, OR 97202-5715

Call (503) 236-4654 Map

Mailing address

6311 NW Firwood Drive
Vancouver, WA 98665-8511

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XLMT#4132 (OR)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1003172412

Chung So, LMT(OREGON #4132)'s National Provider Identifier is 1003172412, issued on Apr 10, 2012. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Apr 10, 2012.