Individual
JESSE THOMAS SWIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3220 NW 185TH AVE STE 100, PORTLAND, OR 97229-3492
(503) 290-6636
(503) 213-7100
Mailing address
3220 NW 185TH AVE STE 100, PORTLAND, OR 97229-3492
(503) 290-6636
(503) 213-7100
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23119
OR
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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