Individual
MS. DENISE LYNN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
14754 SW SCHOLLS FERRY RD, BEAVERTON, OR 97007-9113
(503) 358-3385
Mailing address
14754 SW SCHOLLS FERRY RD, BEAVERTON, OR 97007-9113
(503) 358-3385
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19130
OR
Other
Enumeration date
07/07/2012
Last updated
07/11/2012
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