Individual
JOSHUA RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
1217 NE BURNSIDE RD, SUITE 502, GRESHAM, OR 97030-6722
(503) 492-3910
Mailing address
1217 NE BURNSIDE RD, SUITE 502, GRESHAM, OR 97030-6722
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12296
OR
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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