Individual
ETHAN BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
12750 SW 2ND ST STE 203, BEAVERTON, OR 97005-2779
(971) 228-1122
Mailing address
16593 NW OAK CREEK DR, BEAVERTON, OR 97006-7479
(520) 954-6193
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28815
OR
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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