Individual
YEVGENIY EYSMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ND, LMT
Contact information
Practice address
11667 NE GLISAN ST, PORTLAND, OR 97220-2264
(971) 420-2102
Mailing address
11667 NE GLISAN ST, PORTLAND, OR 97220-2264
(971) 420-2102
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
4306
OR
225700000X
Massage Therapist
23604
OR
Other
Enumeration date
11/05/2019
Last updated
03/30/2021
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