Individual
GINA DURAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2625 SE HAWTHORNE BLVD, PORTLAND, OR 97214-2941
(503) 238-9788
Mailing address
2625 SE HAWTHORNE BLVD, PORTLAND, OR 97214-2941
(503) 238-9788
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
OR14128
OR
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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