Individual
LAURA HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9612 N ADRIATIC AVE, PORTLAND, OR 97203-1974
(971) 420-6807
Mailing address
9612 N ADRIATIC AVE, PORTLAND, OR 97203-1974
(971) 420-6807
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24869
OR
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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