James Leeman Wallace, LMT Valid NPI
Individual provider · Massage Therapist · Wilsonville, OR
- NPI
- 1841591559
- Type
- Individual (Type 1)
- Primary specialty
- Massage Therapist
- Specialty group
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Taxonomy code
- 225700000X
- License number
- 11808 (OR)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2010-11-11
- Last updated
- 2010-11-11
Practice location
29650 Sw Courtside Dr, #14
Wilsonville, OR 97070-7482
(503) 682-6774