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Individual

JOHNATHEN LEE BURKHART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
3835 SW 185TH AVE STE 400, BEAVERTON, OR 97078-1553
(503) 626-2166
Mailing address
7645 SW 66TH AVE, PORTLAND, OR 97223-9403
(971) 230-4830

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28438
OR

Other

Enumeration date
07/05/2024
Last updated
07/05/2024
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