Individual
MARIANA ORANTES BLACKSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16011 NE HALSEY ST, PORTLAND, OR 97230-5629
(503) 901-8992
Mailing address
16011 NE HALSEY ST, PORTLAND, OR 97230-5629
(503) 901-8992
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
21453
OR
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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