Individual
AMANDA MCCRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
7045 MONTAUK CIR, LAKE OSWEGO, OR 97035-7828
(503) 470-9161
Mailing address
7045 MONTAUK CIR, LAKE OSWEGO, OR 97035-7828
(503) 470-9161
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
10973
OR
Other
Enumeration date
12/09/2008
Last updated
12/09/2008
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