Individual
MR. PHOENIX GREENMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3327 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5046
(503) 577-5512
Mailing address
836 NE 78TH AVE, PORTLAND, OR 97213-6957
(503) 577-5512
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
15823
OR
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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