Individual
ALESHIA K LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7689 SW CAPITOL HWY, PORTLAND, OR 97219-2475
(503) 445-4454
Mailing address
11675 SW TRIGARD DR, TIGARD, OR 97223
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
17530
OR
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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