Individual
JIM KARL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2505 SW SPRING GARDEN ST STE 100, PORTLAND, OR 97219-3966
(503) 841-6222
(503) 841-6199
Mailing address
5410 SW 42ND AVE, PORTLAND, OR 97221-3567
(503) 975-8229
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26107
OR
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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