Individual
MS. MARTHA G LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2303 E BURNSIDE ST, PORTLAND, OR 97214-1655
(503) 287-7733
Mailing address
3942 NE 8TH AVE, PORTLAND, OR 97212-1205
(503) 729-1460
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14177
OR
Other
Enumeration date
12/29/2008
Last updated
02/23/2009
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