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Individual

DAWN MARIE CROSLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, CPC

Contact information

Practice address
17310 CROWNVIEW DR, GLADSTONE, OR 97027-1114
(386) 366-0998
Mailing address
17310 CROWNVIEW DR, GLADSTONE, OR 97027-1114
(386) 366-0998

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
8325
OR
174400000X
Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8325
MASSAGE LICENSE
OR
Enumeration date
03/31/2016
Last updated
03/31/2016
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