Individual provider · Type 1 NPI

Lyle Dettloff

Massage Therapist · Portland, OR

NPI number 1154985208 Active

Practice location

728 NE Dekum St
Portland, OR 97211-3628

Call (503) 568-1906 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XNone listed

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 1154985208

Lyle Dettloff's National Provider Identifier is 1154985208, issued on Apr 24, 2019. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Apr 24, 2019.