Individual
KATHLEEN WARNER MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMT
Contact information
Practice address
2400 SW VERMONT ST, PORTLAND, OR 97219-1940
(503) 452-0915
Mailing address
9265 SW 8TH DR, PORTLAND, OR 97219-4753
(503) 869-8429
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1781
OR
Other
Enumeration date
09/15/2010
Last updated
09/16/2010
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