Individual
NASTASSIA LEE-ANN BIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
235 W D ST, JACKSONVILLE, OR 97530-0038
(707) 225-7650
Mailing address
PO BOX 74, WILLIAMS, OR 97544-0074
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24301
OR
Other
Enumeration date
06/06/2022
Last updated
06/30/2022
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