Individual
GREGORY GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1748 NW FAIRVIEW DR, GRESHAM, OR 97030-3842
(503) 492-3910
(503) 674-6706
Mailing address
5030 SE 85TH AVE, PORTLAND, OR 97266-3120
(505) 575-5459
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16352
OR
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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