Individual
CORNELIA ELIZABETH PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, LMT
Contact information
Practice address
3856 SE IVON ST, PORTLAND, OR 97202-1679
(503) 730-7797
Mailing address
3856 SE IVON ST, PORTLAND, OR 97202-1679
(503) 730-7797
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
14460
OR
Other
Enumeration date
12/10/2008
Last updated
12/10/2008
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