Individual
MS. LAURA ANN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4118 SE YAMHILL ST, PORTLAND, OR 97214-4447
(781) 718-5901
Mailing address
4118 SE YAMHILL ST, PORTLAND, OR 97214-4447
(781) 718-5901
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14167
OR
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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