Individual
JON E DARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP, LMT
Contact information
Practice address
2705 E BURNSIDE ST STE 104, PORTLAND, OR 97214-1767
(503) 893-4022
Mailing address
2705 E BURNSIDE ST STE 104, PORTLAND, OR 97214-1767
(503) 893-4022
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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