Individual
MS. ALEXANDRA ROSE DEVIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12700 SW NORTH DAKOTA ST STE 180, TIGARD, OR 97223-0802
(503) 716-8281
Mailing address
9362 SW SUTTON PL, TIGARD, OR 97223-1212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22729
OR
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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