Individual provider · Type 1 NPI

Carissa Ann Clark, LMT

Massage Therapist · Portland, OR

NPI number 1194492371 Active

Practice location

2188 SW Park Pl Ste 10
Portland, OR 97205-1100

Call (503) 568-1390 Map

Other practice locations

  • 10029 SW Nimbus Ave Ste 230, Beaverton, OR 97008-7110 · (503) 372-6035

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.

3 other providers at this address

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About NPI 1194492371

Carissa Ann Clark, LMT's National Provider Identifier is 1194492371, issued on Aug 25, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Aug 25, 2021.