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Individual

IARA SAPOZNIKOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT, CPM, LDM, CA

Contact information

Practice address
1411 NE BROADWAY ST, PORTLAND, OR 97232-1485
(971) 236-2592
Mailing address
4607 NE 52ND AVE, PORTLAND, OR 97218-2014
(845) 642-8446

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
OR
225700000X
Massage Therapist
Primary
23904
OR

Other

Enumeration date
01/31/2018
Last updated
01/31/2018
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