Individual
MICHELLE R THIOUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5013 SE HAWTHORNE BLVD, PORTLAND, OR 97215-3255
(949) 945-8240
Mailing address
5110 NE COUCH ST, PORTLAND, OR 97213-3022
(949) 945-8240
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15853
OR
Other
Enumeration date
05/12/2011
Last updated
04/19/2018
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