Individual
MR. CLINT DOUGLAS DEADMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4515 SW CORBETT AVE STE 102, PORTLAND, OR 97239-4289
(503) 224-5464
Mailing address
4515 SW CORBETT AVE STE 102, PORTLAND, OR 97239-4289
(503) 224-5464
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24121
OR
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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