Individual
KATHRYN FAWLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1514 MADELYN AVE SE, SALEM, OR 97306-3553
(360) 561-7521
Mailing address
1514 MADELYN AVE SE, SALEM, OR 97306-3553
(360) 561-7521
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
00024741
WA
225700000X
Massage Therapist
Primary
19585
OR
Other
Enumeration date
11/30/2010
Last updated
01/27/2015
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