Individual
BRANDIN MICHELLE THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
21974 NE HIGHWAY 240, NEWBERG, OR 97132-6859
(503) 550-5083
(503) 538-3797
Mailing address
PO BOX 222, NEWBERG, OR 97132-0222
(503) 550-5083
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11652
OR
Other
Enumeration date
07/18/2006
Last updated
09/30/2011
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