Individual
DANIELLE BUSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4224 NE HALSEY ST, 325, PORTLAND, OR 97213-1538
(503) 505-6181
Mailing address
1742 NE SARATOGA ST, PORTLAND, OR 97211-4732
(253) 740-8257
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19066
OR
Other
Enumeration date
08/30/2012
Last updated
08/09/2013
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