Individual
MARINA VASILEVNA MCGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
88267 TERRITORIAL RD STE 12, VENETA, OR 97487-9499
(541) 840-4934
Mailing address
25113 LAMB RD, ELMIRA, OR 97437-9743
(541) 840-4934
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24447
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24447
LICENSED MASSAGE THERAPY
OR
Enumeration date
10/25/2018
Last updated
11/13/2020
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