Individual
DOUGLAS MEACHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
123 E POWELL BLVD, # 304, GRESHAM, OR 97030-7624
(503) 319-7142
Mailing address
123 E POWELL BLVD, # 304, GRESHAM, OR 97030-7624
(503) 319-7142
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12196
OR
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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