Individual
JOSHUA JAMES DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
837 E POWELL BLVD, GRESHAM, OR 97030-7617
(503) 669-9495
Mailing address
16351 SE SCORIA LN, DAMASCUS, OR 97089-9136
(503) 853-6527
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19744
OR
Other
Enumeration date
06/01/2013
Last updated
06/01/2013
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