Individual
AIMEE MAUCK LASICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 N PRESCOTT ST, APT 411, PORTLAND, OR 97217-3202
(503) 780-7195
(503) 288-8972
Mailing address
1450 N PRESCOTT ST, APT 411, PORTLAND, OR 97217-3202
(503) 780-7195
(503) 288-8972
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14598
OR
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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