Individual
ANDREA MAE TRADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
384 Q ST, SPRINGFIELD, OR 97477-2140
(541) 514-4819
Mailing address
PO BOX 5178, EUGENE, OR 97405-0178
(541) 295-2198
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
225700000X
Massage Therapist
Primary
23639
OR
Other
Enumeration date
08/27/2012
Last updated
01/20/2022
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