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Individual

KARA LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T,

Contact information

Practice address
651 ROXE DR, FOREST GROVE, OR 97116-1581
(503) 707-5334
Mailing address
651 ROXE DR, FOREST GROVE, OR 97116-1581

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
16656
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16656
LICENSED MASSAGE THERAPIST
Enumeration date
10/06/2009
Last updated
10/06/2009
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