Individual
DAVID EAGLE JONES-HACKATHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
333 NE RUSSELL ST STE 200, PORTLAND, OR 97212-3762
(503) 289-1390
Mailing address
9225 N BURR AVE, PORTLAND, OR 97203-2439
(503) 753-9516
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22951
OR
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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