Organization
MODAGRANT
Active
Other names
Natural Abundance Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONIKA GRANT LMT/ESTHETICIAN (OWNER)
(503) 307-3461
Entity
Organization
Contact information
Practice address
5622 SE TOLMAN ST, PORTLAND, OR 97206-6861
(503) 307-3461
Mailing address
5622 SE TOLMAN ST, PORTLAND, OR 97206-6861
(503) 307-3461
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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