Doctor Name: | AMY JOHANNA ROSE |
NPI Number: | 1871929315 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 6386 |
Business Practice Address: | 10600 Se Mcloughlin Blvd Ste 102 Milwaukie, OR - 972227428 |
Business Phone Number: | 5035755937 |
Business Fax Number: | |
Mailing Address: | 8422 N Willamette Blvd, PORTLAND |
State: | OR |
Postal Code: | 972035346 |
Phone Number: | 5035755937 |
Fax Number: | |
NPI Enumeration Date: | 09/16/2013 |
NPI Last Update Date: | 09/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 6386 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |