Individual
JONATHAN DENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
7052 SW NYBERG ST, TUALATIN, OR 97062-9231
(503) 766-3366
(503) 766-3366
Mailing address
18121 SE RIVER RD # 14-14, MILWAUKIE, OR 97267-6021
(503) 781-2494
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12823
OR
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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