Individual
NICOLETTE WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4922 N VANCOUVER AVE, PORTLAND, OR 97217-2826
(503) 493-9398
Mailing address
2809 N HALLECK ST, PORTLAND, OR 97217-6321
(503) 680-4018
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14486
OR
Other
Enumeration date
01/28/2009
Last updated
11/03/2014
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