Provider Demographics
NPI:1982849709
Name:GARCIA, DALENA ANN (LMT)
Entity Type:Individual
Prefix:
First Name:DALENA
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2211
Mailing Address - Country:US
Mailing Address - Phone:503-270-9384
Mailing Address - Fax:503-656-0649
Practice Address - Street 1:419 CENTER ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2211
Practice Address - Country:US
Practice Address - Phone:503-270-9384
Practice Address - Fax:503-656-0649
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15185174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist