Individual
BREE AUDRESE BIZZELL-MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
936 SE ANKENY ST, PORTLAND, OR 97214-1300
(503) 232-3215
Mailing address
936 SE ANKENY ST, PORTLAND, OR 97214-1300
(503) 232-3215
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24021
OR
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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