Individual
G'ANNA DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1173 2ND ST NW, SALEM, OR 97304-4003
(971) 218-0607
Mailing address
1173 2ND ST NW, SALEM, OR 97304-4003
(971) 218-0607
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15129
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15129
STATE OF OREGON BOARD OF MASSAGE THERAPISTS
OR
Enumeration date
05/04/2012
Last updated
05/04/2012
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