Individual
CHAD THOMAS WARKENTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1809 NW DAVIS ST, PORTLAND, OR 97209-2145
(503) 226-8010
Mailing address
4132 SE WASHINGTON ST, PORTLAND, OR 97214-3274
(503) 710-4977
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11949
OR
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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