Individual
MS. NICHOLE M SANDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1360 SW 176TH TER, BEAVERTON, OR 97006-7562
(503) 933-2112
Mailing address
1360 SW 176TH TER, BEAVERTON, OR 97006-7562
(503) 933-2112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16839
OR
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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