Individual
MR. KENNETH ALAN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.MT.
Contact information
Practice address
14780 SW OSPREY DR, SUITE 350, BEAVERTON, OR 97007-8028
(503) 708-1082
Mailing address
14780 SW OSPREY DR, SUITE 350, BEAVERTON, OR 97007-8028
(503) 708-1082
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10956
OR
Other
Enumeration date
11/01/2007
Last updated
11/01/2007
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