Sandra Renee Fairchild, LMT

NPI #1962125294 in Gresham, Oregon

Provider Information

NPI Number: 1962125294
Entity Type: Individual
Name: Sandra Renee Fairchild, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Sep 21, 2022
Last Updated: Sep 21, 2022

Practice Location

Address: 24076 SE STARK ST STE 310
City: Gresham
State: Oregon
ZIP Code: 97030-3386
Phone: (503) 502-4570

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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