Individual provider · Type 1 NPI

Georgia Fountas, LMT

Massage Therapist · Gresham, OR

NPI number 1073869707 Active

Practice location

22400 SE Stark St, Suite 104
Gresham, OR 97030-2656

Call (503) 491-5555 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X19041 (OR)
Massage Therapist 225700000X1113 (MD)

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 1073869707

Georgia Fountas, LMT's National Provider Identifier is 1073869707, issued on Jul 31, 2012. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Gresham, OR. The record was last updated on Jul 31, 2012.