Individual
JEREMY R RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3523 FAIRVIEW INDUSTRIAL DR SE, SALEM, OR 97302-1155
(971) 453-0800
Mailing address
154 SE FOUNDATION DR, DALLAS, OR 97338-9787
(971) 240-8484
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28270
OR
Other
Enumeration date
05/15/2024
Last updated
06/22/2025
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