Individual
DIANNE L PERNETTI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4426 SE 34TH AVE, PORTLAND, OR 97202
(503) 775-4735
Mailing address
4426 SE 34TH AVE, PORTLAND, OR 97202
(503) 775-4735
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5464
OR
Other
Enumeration date
05/11/2006
Last updated
07/08/2007
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