Individual
NIKOLE STORMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4675 CAMPBELL DR SE APT267, SALEM, OR 97317
(503) 580-3150
Mailing address
4675 CAMPBELL DR SE # APR267, SALEM, OR 97317-6575
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18358
OR
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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