Individual
MARIAM DOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 MONROE PKWY, SUITE U, LAKE OSWEGO, OR 97035-1486
(503) 387-3205
Mailing address
2170 NE HANCOCK ST, 305, PORTLAND, OR 97212-4774
(206) 779-3655
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19468
OR
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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