Individual
BRENT BABAUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
LMT
Contact information
Practice address
15280 NW CENTRAL DR STE 102, PORTLAND, OR 97229-7807
(503) 533-5614
Mailing address
20647 NW SEDONA LN, BEAVERTON, OR 97006-2037
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19062
OR
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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