Individual
NICHOLE CARNESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1831 SE 7TH AVE, #201, PORTLAND, OR 97214-3578
(503) 766-3664
Mailing address
1831 SE 7TH AVE, #201, PORTLAND, OR 97214-3578
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13031
OR
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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