Individual
LARISA NOONAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3804 SE BELMONT ST, PORTLAND, OR 97214-4330
(503) 975-3300
Mailing address
597 W VISTA AVE S, SALEM, OR 97302-5573
(503) 975-3300
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
9384
OR
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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