Individual
OLAF MCLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2819 SW FAIRVIEW BLVD, PORTLAND, OR 97205-5826
(503) 927-4065
Mailing address
2819 SW FAIRVIEW BLVD, PORTLAND, OR 97205-5826
(503) 927-4065
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21842
OR
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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