Individual
MICHAEL IAN GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
124 SW YAMHILL ST, PORTLAND, OR 97204-3019
(971) 279-3591
Mailing address
1020 SE 7TH AVE, 15248, PORTLAND, OR 97293-0856
(971) 279-3591
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7888
OR
Other
Enumeration date
02/14/2013
Last updated
02/14/2013
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