Individual
LAURA ISABEL CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6047 SCONCE RD, HUBBARD, OR 97032-9447
(503) 939-2339
Mailing address
6047 SCONCE RD, HUBBARD, OR 97032-9447
(503) 939-2339
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023464
OR
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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