Individual
LACEY LEE HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7440 SW HUNZIKER ST STE B, TIGARD, OR 97223-8243
(503) 598-9889
Mailing address
7440 SW HUNZIKER ST STE B, TIGARD, OR 97223-8243
(503) 598-9889
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19764
OR
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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