Individual
PAUL HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2722 SW RUTLAND TER, PORTLAND, OR 97205-5854
(971) 601-6154
Mailing address
2722 SW RUTLAND TER, PORTLAND, OR 97205-5854
(971) 601-6154
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26393
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26393
OREGON LICENSE NUMBER
OR
Enumeration date
06/28/2022
Last updated
06/28/2022
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