Individual
MR. BENJAMIN ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10303 NE WEIDLER ST., PORTLAND, OR 97200-3882
(503) 255-0306
Mailing address
10303 NE WEIDLER ST, PORTLAND, OR 97220-3882
(503) 255-0306
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21846
OR
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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