Individual
BRODIE NICHOLAS SHINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2167 NW 185TH AVE, HILLSBORO, OR 97124-7074
(503) 420-6467
Mailing address
12224 NW BARNES RD APT 107, PORTLAND, OR 97229-5956
(503) 420-6467
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25773
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25773
EAST WEST SCHOOL OF NATURAL HEALING
OR
Enumeration date
10/20/2022
Last updated
10/20/2022
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