Individual
ETHAN JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4253 SE 182ND AVE, GRESHAM, OR 97030-5083
(503) 661-5090
Mailing address
892 E HISTORIC COLUMBIA RIVER HWY, TROUTDALE, OR 97060-2166
(309) 370-9379
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25719
OR
Other
Enumeration date
03/16/2020
Last updated
03/16/2020
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