Kelly Ann Stark

NPI #1104332006 in Hillsboro, Oregon

Provider Information

NPI Number: 1104332006
Entity Type: Individual
Name: Kelly Ann Stark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Dec 15, 2017
Last Updated: Dec 15, 2017

Practice Location

Address: 2167 NW 185TH AVE
City: Hillsboro
State: Oregon
ZIP Code: 97124-7074
Phone: (503) 336-3456

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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