Individual
KANA MOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
144 E 14TH AVE, EUGENE, OR 97401-3533
(541) 359-9942
Mailing address
144 E 14TH AVE, EUGENE, OR 97401-3533
(541) 359-9942
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12091
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93029
PACIFICSOURCE
OR
Enumeration date
10/02/2012
Last updated
10/11/2016
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