Individual
ANDRE RAYMOND LAURIER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
17221 SE DIVISION ST, PORTLAND, OR 97236-1240
(503) 760-0778
Mailing address
9885 SW HALITE CT, BEAVERTON, OR 97007-8383
(503) 443-9096
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19218
OR
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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