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Individual
SUZANNE BONNEN
Active
Individual
SUZANNE BONNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT 16652
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16652
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16652
OREGON BOARD OF MASSAGE
OR
Enumeration date
01/18/2017
Last updated
01/18/2017
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