Individual provider · Type 1 NPI

Pamela Diane Peterson, LMT

Massage Therapist · Gresham, OR

NPI number 1609186709 Active

Practice location

1155 NE Hogan Dr
Gresham, OR 97030-4129

Call (503) 706-8271 Map

Mailing address

838 SW Morgan Way
Troutdale, OR 97060-1561

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X16817 (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 1609186709

Pamela Diane Peterson, LMT's National Provider Identifier is 1609186709, issued on Oct 7, 2010. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Gresham, OR. The record was last updated on Oct 7, 2010.