Provider Demographics
NPI:1013263540
Name:ASHBY, BREE MICHELE
Entity Type:Individual
Prefix:MRS
First Name:BREE
Middle Name:MICHELE
Last Name:ASHBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 JEFFERSON PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1252
Mailing Address - Country:US
Mailing Address - Phone:971-245-3683
Mailing Address - Fax:
Practice Address - Street 1:412 JEFFERSON PKWY STE 204
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-1252
Practice Address - Country:US
Practice Address - Phone:971-245-3683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18545225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist