Individual provider · Type 1 NPI

Kaitlyn Douglas, LMT

Massage Therapist · Portland, OR

NPI number 1962017459 Active

Practice location

7817 SE Stark St
Portland, OR 97215-2339

Call (503) 975-5298 Map

Fax (503) 546-7496

Mailing address

3246 NE 49th Ave
Portland, OR 97213-1849

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X25073 (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 1962017459

Kaitlyn Douglas, LMT's National Provider Identifier is 1962017459, issued on Sep 10, 2020. 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, 2020.