Individual
MASON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LAC
Contact information
Practice address
80 SE MADISON ST STE 216, PORTLAND, OR 97214
(503) 748-9399
Mailing address
80 SE MADISON ST STE 216, PORTLAND, OR 97214-4527
(503) 748-9399
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
184969
OR
225700000X
Massage Therapist
20000
OR
Other
Enumeration date
09/26/2017
Last updated
11/19/2019
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