Individual
ANDRINE LOUISE DE LA ROCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4445 NE FREMONT ST, PORTLAND, OR 97213-1153
(503) 249-7752
Mailing address
4445 NE FREMONT ST, PORTLAND, OR 97213-1153
(503) 249-7752
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6161
OR
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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