Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 18545 | OR |
NPI | 1013263540 |
---|---|
Provider Name | Mrs. Bree Michele Ashby |
First Address | Lake Oswego, OR 97035-1252 |
Second Address | Lake Oswego, OR 97035-1252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2012 |
Last Update Date | 02/08/2012 |