Individual
MICHELLE FARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
164 N. ELM ST, SISTERS, OR 97759
(541) 213-9059
Mailing address
782 S ASH ST, SISTERS, OR 97759-1010
(541) 213-9059
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21166
OR
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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