Individual
MRS. MARLENA RAE RAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
11238 SE 21ST AVE STE 2, MILWAUKIE, OR 97222-7763
(503) 819-8793
Mailing address
11238 SE 21ST AVE STE 2, MILWAUKIE, OR 97222-7763
(503) 819-8793
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10164
OR
Other
Enumeration date
07/03/2007
Last updated
03/08/2018
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