Individual
MIKHAEL RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6030 SE 52ND AVE STE 202, PORTLAND, OR 97206-6887
(971) 285-4845
Mailing address
2190 SW 18TH CT, GRESHAM, OR 97080-9716
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27584
OR
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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