Blueprint for Balance

NPI #1083971378 in Portland, Oregon

Provider Information

NPI Number: 1083971378
Entity Type: Organization
Organization Name: Blueprint for Balance
Primary Specialty: Specialist
Enumeration Date: Apr 12, 2012
Last Updated: Apr 12, 2012

Practice Location

Address: 7 SE 30TH AVE
City: Portland
State: Oregon
ZIP Code: 97214-1902
Phone: (503) 810-4941

Authorized Official

Name: MS. COLLAINE BROOKE FADDIS, LMT
Title: LICENSED MASSAGE THERAPIST
Phone: (503) 810-4941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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