Individual
JASON ERIC CRANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-9700
Mailing address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-5696
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24054
OR
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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