Individual
MISS MARIYA ZAVYALOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1017 SW MORRISON ST STE 411, PORTLAND, OR 97205-2629
(503) 806-7763
Mailing address
12711 SE LYDIA CT, PORTLAND, OR 97236-4909
(503) 806-7763
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20380
OR
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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