Individual
MICAH LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1574 SW 175TH AVE, BEAVERTON, OR 97006-7635
(503) 888-3863
Mailing address
1574 SW 175TH AVE, BEAVERTON, OR 97006-7635
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
17945
OR
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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