Individual
MR. ANDREW DAQUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
310 NE 106TH AVE, PORTLAND, OR 97220-4133
(360) 621-8901
Mailing address
310 NE 106TH AVE, PORTLAND, OR 97220-4133
(360) 621-8901
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23752
OR
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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