Individual
JESSE ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
833 SE MAIN ST, PORTLAND, OR 97214-3454
(503) 739-0936
Mailing address
5366 SE ALDERWAY AVE, MILWAUKIE, OR 97267-5005
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21012
OR
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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