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1912343047
FIONA GRACE WAGNER
PORTLAND, OR
NPI
1912343047
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 19740)
Enumeration Date
2013-05-15
Last Update Date
2013-05-15
Business Address
Mrs. FIONA GRACE WAGNER L.M.T
10230 SW HALL BLVD
PORTLAND, OR 97223-5804
Phone number: 503-806-4591
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Mailing Address
Mrs. FIONA GRACE WAGNER L.M.T
11705 NW VALLEVUE CT
PORTLAND, OR 97229-5076
Phone number: 503-641-8002
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