Individual
MR. JOHN SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3324 NE 61ST AVE, PORTLAND, OR 97213-3934
(503) 750-5124
Mailing address
3324 NE 61ST AVE, PORTLAND, OR 97213-3934
(503) 750-5124
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14643
OR
Other
Enumeration date
03/30/2009
Last updated
03/30/2009
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