Individual
EDGAR GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
17777 LOWER BOONES FERRY RD STE A, LAKE OSWEGO, OR 97035-5398
(503) 699-5888
Mailing address
5989 SE HARMONY RD APT 12, MILWAUKIE, OR 97222-2111
(503) 840-7462
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20741
OR
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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