Individual
MRS. DIANE E SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4721 NE 25 AVE, PORTLAND, OR 97211-6435
(503) 281-3406
Mailing address
4721 NE 25 AVE, PORTLAND, OR 97211-6435
(503) 281-3406
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7787
OR
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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