Individual
ALEXANDER DOUGLAS PACKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8695 SW JACK BURNS BLVD STE E, WILSONVILLE, OR 97070-5797
(503) 427-4698
Mailing address
21301 MAIN ST NE, AURORA, OR 97002-9243
(503) 449-4334
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20647
OR
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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