Individual
MR. BRIAN DARYL BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
15495 SW SEQUOIA PKWY, STE. #150, TIGARD, OR 97224-6100
(503) 957-0338
(503) 726-1152
Mailing address
15495 SW SEQUOIA PKWY, STE. #150, TIGARD, OR 97224-6100
(503) 957-0338
(503) 726-1152
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10755
OR
Other
Enumeration date
11/13/2007
Last updated
08/04/2009
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