Individual
MR. JEREMY BARNEY MANALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LMT
Contact information
Practice address
0333 SW FLOWER ST, PORTLAND, OR 97239-3754
(503) 349-2281
Mailing address
0333 SW FLOWER ST, PORTLAND, OR 97239-3754
(503) 349-2281
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3076
OR
225700000X
Massage Therapist
10179
OR
Other
Enumeration date
03/22/2013
Last updated
12/09/2015
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