Individual
OVIDIU STANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
12704 SE MARKET ST, PORTLAND, OR 97233-1245
(503) 704-1841
Mailing address
12704 SE MARKET ST, PORTLAND, OR 97233-1245
(503) 704-1841
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21693
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21693
LICENSE MASSAGE THERAPIST
OR
Enumeration date
09/13/2016
Last updated
09/13/2016
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