Individual
MICHELLE RENEE THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
21974 NE HIGHWAY 240, NEWBERG, OR 97132-6859
(503) 550-5083
Mailing address
906 SW ALDER ST UNIT 17, DUNDEE, OR 97115-9776
(503) 332-5522
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18568
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396029914
MASSAGE THERAPY
OR
Enumeration date
02/02/2012
Last updated
02/02/2012
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