Individual
LAURIE N NIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3241 NE BROADWAY ST, PORTLAND, OR 97232-1814
(503) 282-8582
Mailing address
1611 SE WOODWARD ST, PORTLAND, OR 97202-2257
(206) 458-2042
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26145
OR
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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