Individual
LACEY FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
13590 NW MAIN ST, BANKS, OR 97106-9057
(971) 205-2023
Mailing address
13590 NW MAIN ST, BANKS, OR 97106-9057
(971) 205-2023
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19944
OR
Other
Enumeration date
05/16/2014
Last updated
12/21/2023
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