Individual
LEEANN MARIE MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
455 S 4TH ST STE 7, COOS BAY, OR 97420-1546
(541) 260-5179
(541) 808-2433
Mailing address
PO BOX 1184, COOS BAY, OR 97420-0311
(541) 260-5179
(541) 808-2433
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15903
OR
Other
Enumeration date
03/19/2012
Last updated
03/19/2012
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