Individual provider · Type 1 NPI

Shane Stark, MEDICAL MASSAGE LMT

Massage Therapist · Portland, OR

NPI number 1205593191 Active

Practice location

6700 E Burnside St
Portland, OR 97215-1051

Call (503) 627-7243 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X19432 (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.

Other massage therapist providers in Portland

See all in Portland →

About NPI 1205593191

Shane Stark, MEDICAL MASSAGE LMT's National Provider Identifier is 1205593191, issued on Nov 26, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Nov 26, 2021.