Individual
SARAH KELLY MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1222 SE DIVISION ST, PORTLAND, OR 97202-1017
(503) 231-9879
(503) 233-4732
Mailing address
1222 SE DIVISION ST, PORTLAND, OR 97202-1017
(503) 231-9879
(503) 233-4732
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14995
OR
Other
Enumeration date
10/10/2008
Last updated
05/31/2013
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