Individual
MR. KIPP LACHANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
833 SW 11TH AVE, SUITE 715, PORTLAND, OR 97205-2125
(503) 358-9638
Mailing address
2755 NE 35TH AVE, PORTLAND, OR 97212-2711
(503) 358-9638
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11845
OR
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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