Individual
MANDY LYNN KRUGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
125 NE KILLINGSWORTH ST, PORTLAND, OR 97211-2625
(971) 227-7567
Mailing address
4004 NE MALLORY AVE APT 2, PORTLAND, OR 97212-1065
(971) 227-7567
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12673
OR
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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