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Individual

MR. DUSTIN RICHARD BODEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC, LMT

Contact information

Practice address
606 120TH AVE NE STE D104, BELLEVUE, WA 98005-3024
(425) 455-5444
(425) 646-8047
Mailing address
1836 NE 7TH AVE #206, PORTLAND, OR 97212
(503) 282-1070
(503) 282-1990

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC189999
OR
225700000X
Massage Therapist
19300
OR
225700000X
Massage Therapist
MA60401348
WA

Other

Enumeration date
10/24/2013
Last updated
12/21/2018
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