Individual
DANIELE K MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2330 NW FLANDERS ST, PORTLAND, OR 97210-3442
(503) 701-8766
Mailing address
1245 NW 53RD DR, PORTLAND, OR 97210-1035
(503) 319-5787
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16908
OR
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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