Individual
NIKKI VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY STE 465, BEAVERTON, OR 97005-4736
(503) 504-2388
Mailing address
4724 SW 38TH PL, PORTLAND, OR 97221-3916
(503) 504-2388
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12197
OR
Other
Enumeration date
11/28/2006
Last updated
02/06/2021
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