Individual
AUDRA SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1659 NE MARKET DR, FAIRVIEW, OR 97024-3867
(503) 465-9100
Mailing address
1659 NE MARKET DR, FAIRVIEW, OR 97024-3867
(503) 465-9100
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13515
OR
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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