Individual
TRINA MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7817 SE STARK ST, PORTLAND, OR 97215-2339
(503) 473-3668
(503) 546-7496
Mailing address
7817 SE STARK ST, PORTLAND, OR 97215-2339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15103
OR
Other
Enumeration date
01/27/2009
Last updated
08/16/2010
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