Individual
CHRISTINA L PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,MT
Contact information
Practice address
7759 SE 72ND AVE, PORTLAND, OR 97206-7921
(503) 788-4500
Mailing address
7759 SE 72ND AVE, PORTLAND, OR 97206-7921
(503) 788-4500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10033689RN
OR
225700000X
Massage Therapist
CAMCT 8567
CA
Other
Enumeration date
05/30/2012
Last updated
04/14/2025
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