Individual provider · Type 1 NPI

Lora Geneva Edmiston, LMT

Massage Therapist · Portland, OR

NPI number 1811209919 Active

Practice location

604 NW 23rd Ave, Suite #2
Portland, OR 97210-3209

Call (503) 708-9049 Map

Mailing address

710 NW Naito Pkwy, C-17
Portland, OR 97209-3758

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X14753 (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 1811209919

Lora Geneva Edmiston, LMT's National Provider Identifier is 1811209919, issued on Jul 6, 2010. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Jul 6, 2010.