Individual
BROOKS BRIASSON FARIS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1070 NW MURRAY RD, SUITE A, PORTLAND, OR 97229-5568
(503) 644-5100
Mailing address
3806 SE IVON ST, PORTLAND, OR 97202-1649
(503) 730-5018
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19135
OR
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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