Organization
M FOR MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL ESPINOZA (CEO)
(503) 477-6121
Entity
Organization
Contact information
Practice address
2534 NW VAUGHN ST, PORTLAND, OR 97210-2552
(503) 477-9028
Mailing address
2534 NW VAUGHN ST, PORTLAND, OR 97210-2552
(503) 477-9028
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12412
OR
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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