Individual
CASEY BROOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
16169 SE 106TH AVE, CLACKAMAS, OR 97015-9699
(503) 784-5623
Mailing address
16169 SE 106TH AVE, CLACKAMAS, OR 97015-9699
(503) 784-5623
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10100
OR
Other
Enumeration date
05/10/2006
Last updated
06/13/2014
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