Individual
BLAIRE M NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5111 SE LAKE RD, MILWAUKIE, OR 97222-4767
(503) 659-5900
Mailing address
5111 SE LAKE RD, MILWAUKIE, OR 97222-4767
(503) 659-5900
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
12271
OR
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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