Individual
MARK DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
566 BROOKSIDE DR, EUGENE, OR 97405-4928
(541) 232-7630
Mailing address
566 BROOKSIDE DR, EUGENE, OR 97405-4928
(541) 232-7630
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14017
OR
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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