Individual
MARYANNE ELIZABETH SCHILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2328 PACIFIC AVE RM 500, FOREST GROVE, OR 97116-2450
(503) 607-9621
Mailing address
2328 PACIFIC AVE RM 500, FOREST GROVE, OR 97116-2450
(503) 607-9621
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25420
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25420
OBMT LICENSE NUMBER
OR
Enumeration date
11/04/2019
Last updated
11/04/2019
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