Individual
LAURA; KUBLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2188 SW PARK PL, SUITE 10, PORTLAND, OR 97205-1100
(503) 568-1390
Mailing address
2188 SW PARK PL, SUITE 10, PORTLAND, OR 97205-1100
(503) 568-1390
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21141
OR
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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