Individual
LILY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2214 NE MCDONALD LN, MCMINNVILLE, OR 97128-2702
(503) 434-6603
(503) 434-6746
Mailing address
2214 NE MCDONALD LN, MCMINNVILLE, OR 97128-2702
(503) 434-6603
(503) 434-6746
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25387
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25387
STATE OF OREGON
OR
Enumeration date
09/13/2019
Last updated
09/13/2019
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