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Individual

GERALD W SKYLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
7831 SE STARK ST, 200, PORTLAND, OR 97215-2357
(503) 757-7295
Mailing address
7831 SE STARK ST, 200, PORTLAND, OR 97215-2357
(503) 757-7295

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6111
OR

Other

Enumeration date
10/15/2012
Last updated
10/15/2012
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