Individual provider · NPI-1

Mariana Orantes Blackstone

Mechanotherapist · Portland, OR

NPI number1336686237
StatusActive
Last updated in NPPESJan 30, 2017

Details

NPI
1336686237
Entity type
Individual (NPI-1)
Name
Mariana Orantes Blackstone
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 30, 2017
Last updated
Jan 30, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172M00000X Mechanotherapist21453ORYes

Practice location

16011 Ne Halsey St
Portland, OR 97230-5629

Phone 503-901-8992

Mailing address

16011 Ne Halsey St
Portland, OR 97230-5629

Phone 503-901-8992

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