Individual
MICHAEL B NICHOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
8810 SE SUNNYBROOK BLVD, STE #100, CLACKAMAS, OR 97015-6843
(503) 607-2226
(503) 659-2276
Mailing address
9721 SE CLATSOP ST, PORTLAND, OR 97266-6102
(702) 336-0392
(503) 788-9974
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17302
OR
Other
Enumeration date
10/22/2013
Last updated
10/22/2013
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