Individual
LENA KASSOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2161 NE BROADWAY ST, PORTLAND, OR 97232-1512
(503) 331-1800
Mailing address
2161 NE BROADWAY ST, PORTLAND, OR 97232-1512
(503) 331-1800
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17982
OR
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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