Individual
HEATHER DENSMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1217 NE BURNSIDE RD STE 502, GRESHAM, OR 97030-5770
(503) 492-3910
Mailing address
4715SW 118TH AVE, PORTLAND, OR 97266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13778
OR
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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