Individual
LILIANA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 SE 73RD AVE, PORTLAND, OR 97215-1440
(925) 250-6236
Mailing address
215 SE 73RD AVE, PORTLAND, OR 97215-1440
(925) 250-6236
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27412
OR
Other
Enumeration date
12/20/2022
Last updated
12/20/2022
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