Individual
MS. AMY ELIZABETH MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6519 SE MILWAUKIE AVE, #202, PORTLAND, OR 97202-5519
(352) 359-2910
Mailing address
11501 SE STEVENS RD, HAPPY VALLEY, OR 97086-7560
(352) 359-2910
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18915
OR
225700000X
Massage Therapist
MA27626
FL
Other
Enumeration date
03/17/2007
Last updated
11/27/2013
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