Individual
MS. LISA ANN VANALSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
6030 SE DIVISION ST, PORTLAND, OR 97206-1346
(503) 772-1215
Mailing address
6030 SE DIVISION ST, PORTLAND, OR 97206-1346
(503) 772-1215
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6740
OR
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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