Individual
JONATHAN PIERCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCSI LMT
Contact information
Practice address
1411 NE BROADWAY ST, PORTLAND, OR 97232-1485
(480) 438-6110
Mailing address
3615 NE 72ND AVE, PORTLAND, OR 97213-5705
(480) 438-6110
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26338
OR
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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