Individual
JASON GENE NEWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, CA
Contact information
Practice address
4314 N MISSISSIPPI AVE, PORTLAND, OR 97217-3135
(503) 476-1515
Mailing address
PO BOX 22741, PORTLAND, OR 97269-2741
(503) 476-1515
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24410
OR
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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