Individual
KARISSA MARIE MENDIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
159 E 15TH AVE APT 2, EUGENE, OR 97401-4083
(541) 485-6915
Mailing address
2452 DALE AVE, EUGENE, OR 97408-4617
(541) 485-6915
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10172
OR
Other
Enumeration date
08/11/2010
Last updated
11/27/2020
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