Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 17126 | OR |
NPI | 1013220540 |
---|---|
Provider Name | Kristina Marie Morano |
First Address | Hillsboro, OR 97124-7107 |
Second Address | Hillsboro, OR 97124-7107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2010 |
Last Update Date | 21/03/2012 |