Individual
CANDI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
200 E HANCOCK ST, NEWBERG, OR 97132-2824
(503) 538-1114
Mailing address
PO BOX 474, NEWBERG, OR 97132-0474
(503) 538-1114
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1752
OR
Other
Enumeration date
12/30/2009
Last updated
12/30/2009
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