Individual
DIANE ROCKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
631 SE 81ST AVE, PORTLAND, OR 97215-2309
(541) 613-0545
Mailing address
12208 NW BARNES RD APT 225, PORTLAND, OR 97229-6024
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20483
OR
Other
Enumeration date
06/26/2017
Last updated
03/29/2021
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