Individual
JEROME MARKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
914 SW 11TH AVE, PORTLAND, OR 97205-2001
(503) 765-5333
Mailing address
914 SW 11TH AVE, PORTLAND, OR 97205-2001
(503) 765-5333
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18255
OR
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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