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Individual

MS. MARISSA HANTHORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ND, LAC

Contact information

Practice address
1330 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-4322
(503) 232-1100
Mailing address
9009 SE ADAMS ST UNIT 3344, CLACKAMAS, OR 97015-1180
(971) 222-6506

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC195483
OR
175F00000X
Naturopath
Primary
4341
OR
225700000X
Massage Therapist
22305
OR

Other

Enumeration date
08/02/2016
Last updated
08/06/2021
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