Individual
JEREMY RYAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2167 NW 185TH AVE, HILLSBORO, OR 97124-7074
(503) 828-1311
Mailing address
832 SE WOODROW LN, HILLSBORO, OR 97123-4868
(971) 312-5737
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20589
OR
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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