Individual
MRS. MICHELLE MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3689 CARMAN DR STE 300, LAKE OSWEGO, OR 97035-2620
(503) 515-5579
(503) 697-7810
Mailing address
14044 CHELSEA DRIVE, LAKE OSWGO, OR 97035-5760
(503) 515-5579
(503) 697-7810
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21023
OR
Other
Enumeration date
09/23/2016
Last updated
09/01/2020
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