Individual
MCSONCHAR ELIAZAR MONTHERVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10365 SE SUNNYSIDE RD STE 210, CLACKAMAS, OR 97015-5749
(503) 887-7725
(503) 855-3269
Mailing address
10365 SE SUNNYSIDE RD STE 210, CLACKAMAS, OR 97015-5749
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27066
OR
Other
Enumeration date
07/05/2022
Last updated
09/06/2022
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