Individual
MITCHELL T FOSNAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
844 N EMERSON ST, PORTLAND, OR 97217-2533
(206) 503-1536
Mailing address
844 N EMERSON ST, PORTLAND, OR 97217-2533
(206) 503-1536
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29526
OR
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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