Individual
JONATHAN GRANT SUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
917 SW OAK ST, SUITE 300, PORTLAND, OR 97205-2829
(910) 818-0560
Mailing address
3044 SE 7TH AVE, PORTLAND, OR 97202-2607
(910) 818-0560
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
154068
OR
Other
Enumeration date
04/25/2011
Last updated
08/02/2011
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