Individual
MR. EDWIN JON WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1939 NE BROADWAY ST, STE C, PORTLAND, OR 97232-1583
(503) 757-3475
(503) 281-0008
Mailing address
1403 SE 37TH AVE APT 3, PORTLAND, OR 97214-5166
(503) 757-3475
(503) 281-0008
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10626
OR
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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