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Individual

MR. BENJAMIN CARLOS MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
5010 NE 33RD AVE, PORTLAND, OR 97211-6946
(503) 238-1065
Mailing address
2926 NE FLANDERS ST, PORTLAND, OR 97232-3259
(503) 239-7452

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1073
OR

Other

Enumeration date
02/24/2009
Last updated
02/24/2009
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