Individual
JEFFERY BEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4650 SW MUELLER DR, #D304, BEAVERTON, OR 97078-2506
(503) 954-9176
Mailing address
4650 SW MUELLER DR, #D304, BEAVERTON, OR 97078-2506
(503) 954-9176
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
19957
OR
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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