Individual
THERESA ANN KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
14780 SW OSPREY DR, SUITE NUMBER 350, BEAVERTON, OR 97007-8028
(503) 579-6038
Mailing address
14780 SW OSPREY DR, SUITE NUMBER 350, BEAVERTON, OR 97007-8028
(503) 579-6038
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5034
OR
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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