Individual
DENISE MARIE REAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6125 NE CORNELL RD, SUITE 250, HILLSBORO, OR 97124-5412
(503) 530-8517
Mailing address
2020 NE LOMBARD ST, PORTLAND, OR 97211-5262
(503) 505-2088
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18452
OR
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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