Individual
NICOLE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8695 SW JACK BURNS BLVD, SUITE E, WILSONVILLE, OR 97070-5797
(503) 427-2698
Mailing address
16147 NW CANTON ST, #303, PORTLAND, OR 97229-1110
(610) 413-8361
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21051
OR
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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