Individual
CORINNE CRISTINA LAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15110 BOONES FERRY RD, LAKE OSWEGO, OR 97035-3468
(503) 869-7470
Mailing address
6823 SE CARLTON ST, PORTLAND, OR 97206-6514
(503) 869-7470
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14696
OR
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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