Individual
GARETH THOMAS SICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2149 NE BROADWAY ST, PORTLAND, OR 97232-1580
(503) 281-0278
Mailing address
2047 SW 10TH AVE APT 1, PORTLAND, OR 97201-3127
(206) 902-7552
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25531
OR
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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