Organization
AT EASE MASSAGE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN DARYL BUCKNER L.M.T. (CEO)
(503) 957-0338
Entity
Organization
Contact information
Practice address
15495 SW SEQUOIA PKWY, SUITE 150, TIGARD, OR 97224-6100
(503) 957-0338
Mailing address
15495 SW SEQUOIA PKWY., SUITE 150, TIGARD, OR 97224-6117
(503) 957-0338
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
10755
OR
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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