Individual
MICHAEL JOHN DEFABIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT BS
Contact information
Practice address
8538 SW APPLE WAY, PORTLAND, OR 97225-1772
(503) 520-8743
(503) 297-5565
Mailing address
8538 SW APPLE WAY, PORTLAND, OR 97225-1772
(503) 520-8743
(503) 297-5565
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13396
OR
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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