Individual
MR. CHRISTIAN CROWNINGSHIELD COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1928 NE 40TH AVE, PORTLAND, OR 97212-5310
(503) 287-2787
Mailing address
1617 NE ALBERTA ST, APT 10, PORTLAND, OR 97211-5068
(503) 891-9274
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14624
OR
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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