Individual
MRS. AMANDA RAE HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
601 E. COURT ST, CONDON, OR 97823
(503) 707-7400
Mailing address
P.O. BOX 5, 601 E. COURT ST, CONDON, OR 97823
(503) 707-7400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT023660
OR
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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