Individual provider · Type 1 NPI

Misty Fall, LMT

Massage Therapist · Portland, OR

NPI number 1316460124 Active

Practice location

1016 SE 12th Ave
Portland, OR 97214-2513

Call (971) 303-9557 Map

Mailing address

4912 NE 32nd Ave
Portland, OR 97211-7024

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X23135 (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 1316460124

Misty Fall, LMT's National Provider Identifier is 1316460124, issued on Jul 24, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Jul 24, 2017.