Individual
DANIEL ADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3710 NE SIMPSON ST, PORTLAND, OR 97211-7963
(503) 929-6053
Mailing address
3710 NE SIMPSON ST, PORTLAND, OR 97211-7963
(503) 929-6053
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18289
OR
Other
Enumeration date
09/22/2016
Last updated
01/02/2017
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