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Individual

ALESIA L BABAKOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
12014 SE MILL PLAIN BLVD, S120, VANCOUVER, WA 98684-4043
(360) 891-0199
Mailing address
17223 SE DIVISION ST, PORTLAND, OR 97236-1240
(503) 760-0778

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16263
OR

Other

Enumeration date
08/26/2010
Last updated
08/26/2010
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