Individual
LASHAWN DANIELLE DEGRATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7621 N PORTSMOUTH AVE, PORTLAND, OR 97203-5953
(503) 240-7599
Mailing address
4702 SW SLAVIN RD, APT. 22, PORTLAND, OR 97239-2873
(503) 490-2482
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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