Individual
LISA MARIE MANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1706 NW GLISAN ST, STE 5, PORTLAND, OR 97209-2229
(503) 228-5000
(503) 228-5019
Mailing address
1706 NW GLISAN ST, STE 5, PORTLAND, OR 97209-2229
(503) 228-5000
(503) 228-5019
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18306
OR
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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