Individual
MAURI MCKITRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2928 SE HAWTHORNE BLVD, #104, PORTLAND, OR 97214-4147
(971) 506-4560
Mailing address
4130 NE 54TH AVE, PORTLAND, OR 97218-2110
(971) 506-4560
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
8161
OR
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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