Individual
MR. GEORGE MIYAKE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
2456 NW NORTHRUP ST, SUITE 1-A, PORTLAND, OR 97210-3253
(503) 223-6414
(503) 243-6632
Mailing address
2456 NW NORTHRUP ST, SUITE 1-A, PORTLAND, OR 97210-3253
(503) 223-6414
(503) 243-6632
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15016
OR
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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