Individual
YOUNGTEA SOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
996 NW CIRCLE BLVD STE 101, CORVALLIS, OR 97330-1485
(541) 619-2847
Mailing address
1241 SE RIVERGREEN AVE, CORVALLIS, OR 97333-9288
(541) 619-2847
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
16196
OR
Other
Enumeration date
03/25/2016
Last updated
03/25/2016
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