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1114413010
SAM MACKENZIE LANE
SALEM, OR
NPI
1114413010
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 23778)
Enumeration Date
2018-07-03
Last Update Date
2018-07-03
Business Address
SAM MACKENZIE LANE LMT
1661 EDGEWATER ST NW # 120, SALEM, OR 97304
SALEM, OR 97304
Phone number: 503-580-3961
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Mailing Address
SAM MACKENZIE LANE LMT
1695 ASHLAND CT NW
SALEM, OR 97304-2075
Phone number: 503-931-9178
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