Individual
DIANA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7411 SE POWELL BLVD, PORTLAND, OR 97206-2451
(503) 762-1122
Mailing address
305 NE 26TH AVE, PORTLAND, OR 97232-3115
(910) 987-0601
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27977
OR
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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