Individual
MICHELLE LYNN BOLLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2216 SE 50TH AVE, PORTLAND, OR 97215-3827
(503) 956-9340
Mailing address
2216 SE 50TH AVE, PORTLAND, OR 97215-3827
(503) 956-9340
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15293
OR
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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