Individual
LISA MK SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
16742 SE DIVISION ST, PORTLAND, OR 97236-1414
(503) 761-0252
Mailing address
17010 SE STARK ST, APT. D311, PORTLAND, OR 97233-6205
(503) 262-0907
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10005
OR
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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