Individual
KARIN E WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED ROLFER LMT
Contact information
Practice address
2732 SE 18TH AVE, PORTLAND, OR 97202-2265
(503) 230-0087
Mailing address
2732 SE 18TH AVE, PORTLAND, OR 97202-2265
(503) 230-0087
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11497
OR
Other
Enumeration date
09/04/2007
Last updated
11/20/2012
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