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Individual

JASON LASLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2808 NE MLK BLVD STE C, PORTLAND, OR 97212-3061
(503) 473-8515
Mailing address
1817 SE 130TH AVE, PORTLAND, OR 97233-1413

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21285
OR

Other

Enumeration date
03/13/2019
Last updated
03/13/2019
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