Individual
MR. JORDAN KIMBLE CHARTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
15850 NW CENTRAL DR, PORTLAND, OR 97229-1101
(503) 431-1414
Mailing address
19350 SW MELNORE CT, ALOHA, OR 97006-2807
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16334
OR
Other
Enumeration date
04/02/2010
Last updated
04/02/2010
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