Individual provider · Type 1 NPI

Imia Alexandra Holston, LMT

Massage Therapist · Portland, OR

NPI number 1790334910 Active

Practice location

4515 SW Corbett Ave
Portland, OR 97239-4289

Call (503) 224-5464 Map

Mailing address

4409 NE Killingsworth St Unit 103
Portland, OR 97218-1465

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X25192 (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 1790334910

Imia Alexandra Holston, LMT's National Provider Identifier is 1790334910, issued on Sep 10, 2019. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Sep 10, 2019.