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Individual

MONA LEE MATTHEWS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
5907 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6707
(208) 940-2053
Mailing address
5940 SE 138TH PL, PORTLAND, OR 97236-4402
(208) 940-2053

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19679
OR

Other

Enumeration date
04/24/2013
Last updated
04/24/2013
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