Individual
MS. LORI SUE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6606 SW CAPITOL HWY, PORTLAND, OR 97239-1944
(503) 452-1087
Mailing address
6606 SW CAPITOL HWY, PORTLAND, OR 97239-1944
(503) 452-1087
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3919
OR
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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