Individual
DANIEL WASGATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2149 NE BROADWAY ST, PORTLAND, OR 97232-1580
(503) 281-0278
Mailing address
11253 SE STEVENS RD APT 304, HAPPY VALLEY, OR 97086-4512
(916) 213-2506
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26328
OR
225700000X
Massage Therapist
74867
CA
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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