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Oregon Board of Massage Therapists
Address Change Form
Submit an Address Change
All licensed massage therapists and applicants must notify the Board of any change of residence, business or mailing address within 30 days of change of address [OAR 34-010-0025(7)].  This request must be in writing which includes mailing, faxing, and e-mailing (Crystal.Quatier@state.or.us).  Please do not call the office.

Identify yourself 
Name:  
  OR
License Number:  
   
New Address 
Home Send Mail Here
Street:  
City:  
State:  
Zip:  
Phone:  
   
Business Send Mail Here
Business Name:  
Street:  
City:  
State:  
Zip:  
Phone:  
   
Mailing Send Mail Here
Street:  
City:  
State:  
Zip:  
   
Email Address 
Email Address:  
   
Check if you do NOT want to be added to the mailing list.
 
 

Page updated: October 24, 2011