Individual
LEANIDA POLUSHKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
33933 S MERIDIAN RD, WOODBURN, OR 97071-8774
(907) 399-0708
Mailing address
39173 JEFFREY RD, MONMOUTH, OR 97361-9613
(907) 399-0708
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26488
OR
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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