Individual
BEN SHAFER RICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 N KILLINGSWORTH ST., PORTLAND, OR 97214
(503) 288-4454
Mailing address
118 N KILLINGSWORTH ST., PORTLAND, OR 97214
(503) 288-4454
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21786
OR
225700000X
Massage Therapist
—
—
Other
Enumeration date
11/13/2015
Last updated
03/15/2016
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