Individual
BETHANY GUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1328 NW 6TH ST, GRANTS PASS, OR 97526-1255
(541) 476-4010
(541) 474-6310
Mailing address
PO BOX 774, GRANTS PASS, OR 97528-0066
(541) 476-4010
(541) 474-6310
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9544
OR
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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