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Individual
RON FENNERN
Active
Individual
RON FENNERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11904
OREGON BOARD OF MASSAGE THERAPY
OR
01
—
17659
OREGON BOARD OF MASSAGE THERAPY
OR
01
—
18540
OREGON BOARD OF MASSAGE THERAPY
OR
01
—
21602
OREGON BOARD OF MASSAGE THERAPY
OR
01
—
23534
OREGON BOARD OF MASSAGE THERAPY
OR
Enumeration date
10/16/2018
Last updated
10/16/2018
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