Individual
MR. AUSTIN TYLER DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2216 SE 50TH AVE, PORTLAND, OR 97215-3827
(503) 871-3183
(971) 302-6629
Mailing address
2216 SE 50TH AVE, PORTLAND, OR 97215-3827
(503) 871-3183
(971) 302-6629
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16840
OR
Other
Enumeration date
02/28/2011
Last updated
01/23/2013
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