Individual
DANIELLE FUNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 JOHN ADAMS ST, OREGON CITY, OR 97045-1955
(503) 545-4502
Mailing address
11505 SHELBY ROSE DR, OREGON CITY, OR 97045-7758
(503) 545-4502
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20231
OR
Other
Enumeration date
10/21/2014
Last updated
10/21/2014
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