Individual
DIANE DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
3276 COMMERCIAL ST SE, SALEM, OR 97302-4584
(503) 371-1120
Mailing address
543 W HILLS WAY NW, SALEM, OR 97304-4328
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
17602
OR
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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