Individual
MS. ALINA MARIE WIANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225700000X
Massage Therapist
Primary
21557
OR
Other
Enumeration date
09/28/2015
Last updated
12/14/2018
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