Individual
IVA DUBYAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2933 NE BROADWAY ST, PORTLAND, OR 97232-1760
(503) 960-3366
Mailing address
7902 SE MITCHELL ST, PORTLAND, OR 97206-4252
(510) 706-1633
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27924
OR
Other
Enumeration date
05/25/2024
Last updated
05/25/2024
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