Individual
KAMI MANSELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
725 SE 1ST AVE, CANBY, OR 97013-3810
(503) 266-5858
Mailing address
725 SE 1ST AVE, CANBY, OR 97013-3810
(503) 266-5858
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14910
OR
Other
Enumeration date
06/13/2008
Last updated
06/13/2008
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