Individual
PAULINA THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
625 NW 17TH AVE, PORTLAND, OR 97209-2209
(503) 924-6535
Mailing address
625 NW 17TH AVE, PORTLAND, OR 97209-2209
(503) 924-6535
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20270
OR
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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