Individual
LEE ANTHONY SANTA ANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8706 SE MILL ST, PORTLAND, OR 97216-1913
(503) 504-8905
(503) 777-5766
Mailing address
8706 SE MILL ST, PORTLAND, OR 97216-1913
(503) 504-8905
(503) 777-5766
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10751
OR
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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