Individual
JON E DARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP, LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17071
OR
225700000X
Massage Therapist
MA60040619
WA
Other
Enumeration date
04/13/2009
Last updated
09/27/2020
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