MR. Michael T Mcnicholas

NPI #1942567557 in Tualatin, Oregon

Provider Information

NPI Number: 1942567557
Entity Type: Individual
Name: MR. Michael T Mcnicholas
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Apr 19, 2012
Last Updated: Apr 19, 2012

Practice Location

Address: 7052 SW NYBERG ST
City: Tualatin
State: Oregon
ZIP Code: 97062-9231
Phone: (503) 766-3366

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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