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1154864718
LADEENE M HAGNER
PORTLAND, OR
NPI
1154864718
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 16975)
Enumeration Date
2016-11-29
Last Update Date
2016-11-29
Business Address
-- LADEENE M HAGNER LMT
4620 SW CORONADO ST
PORTLAND, OR 97219-7322
Phone number: 503-820-1829
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Mailing Address
-- LADEENE M HAGNER LMT
4620 SW CORONADO ST
PORTLAND, OR 97219-7322
Phone number: 503-820-1829
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