Individual
MS. MIWA ANDRINA NISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1117 SE 122ND AVE UNIT 1, PORTLAND, OR 97233-1160
(503) 946-8633
Mailing address
9850 SE HAROLD ST, PORTLAND, OR 97266-3735
(503) 260-0288
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5208
OR
Other
Enumeration date
02/05/2022
Last updated
02/05/2022
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