Individual
CARLA DE MARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 418-7246
Mailing address
6810 N BALTIMORE AVE, PORTLAND, OR 97203-5304
(360) 774-6763
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15324
OR
Other
Enumeration date
03/09/2016
Last updated
05/23/2016
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