Individual
VANESSA LAJAUNA MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RTC
Contact information
Practice address
5009 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1915
(503) 402-8116
Mailing address
2537 SE 112TH AVE, PORTLAND, OR 97266-1117
(503) 762-3191
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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