Individual
AMANDA KIRCHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
19300 SW BOONES FERRY RD, TUALATIN, OR 97062-9086
(503) 692-6568
Mailing address
PO BOX 1730, CLACKAMAS, OR 97015-1730
(971) 322-4093
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20672
OR
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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