Individual
NICOLETTE MARIE PENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, CA
Contact information
Practice address
100 E 2ND ST, THE DALLES, OR 97058-1704
(541) 900-5400
Mailing address
1611 NEVADA ST, THE DALLES, OR 97058-3328
(775) 843-0220
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27740
OR
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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