Individual
MS. MARGARET CATHERINE WICKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5073
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019463790-1-1
FARMERS INSURANCE
OK
01
—
108601
PROVIDENCE
OR
01
—
R01543652
HEALTH NET
OR
Enumeration date
07/20/2012
Last updated
03/15/2019
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