Individual
JEFFREY WALTER BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
5010 NE 33RD AVE, PORTLAND, OR 97211-6946
(503) 238-1065
Mailing address
3712 SE HARRISON ST, PORTLAND, OR 97214-5846
(503) 231-7233
(503) 233-0871
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2213
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2213
OREGON STATE LICENSE NUMBER
OR
Enumeration date
09/09/2010
Last updated
09/09/2010
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