Individual
LUCINDA MACKAY AGRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
819 SE MORRISON ST, #340, PORTLAND, OR 97214-6307
(503) 475-0953
Mailing address
2933 SE 20TH AVE, PORTLAND, OR 97202-2234
(503) 475-0953
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4006
OR
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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