Most Relevant Information
Provider Data
| NPI Number: | 1003180928 |
| Provider Name: | MICAH LEE LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 172M00000X |
| Specialty: | Mechanotherapist |
| License Number: | 17945 |
Most Important Dates
| Enumeration Date: | 02/24/2012 |
| Last Updated: | 02/24/2012 |
Provider Practice Location
1574 SW 175TH AVE
BEAVERTON
OR
970067635
Practice Location Phone/Fax
| Phone: | 5038883863 |
| Fax: |
Provider Mailing Location
1574 SW 175TH AVE
BEAVERTON
OR
970067635
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |