Organization
DIANNE PERNETTI LMT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE LAURA PERNETTI LMT (PRES.)
(503) 940-5955
Entity
Organization
Contact information
Practice address
4426 SE 34TH AVE, PORTLAND, OR 97202-3310
(503) 940-5955
Mailing address
4426 SE 34TH AVE, PORTLAND, OR 97202-3310
(503) 940-5955
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
5464
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113218
KAISER PERMENANTE
OR
Enumeration date
04/23/2008
Last updated
04/23/2008
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