Individual
MS. KATHLEEN LEILANI MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
6250 COMMERCIAL ST SE, SALEM, OR 97306-1333
(503) 884-3661
Mailing address
2160 UNIVERSITY ST SE, SALEM, OR 97302-2104
(503) 884-3661
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
5106
OR
225700000X
Massage Therapist
Primary
5106
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5106
LICENSED
OR
Enumeration date
01/29/2010
Last updated
01/29/2010
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