Individual
MR. ANDREW BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2285 NW JOHNSON ST, PORTLAND, OR 97210-3236
(585) 469-0420
Mailing address
2285 NW JOHNSON ST, PORTLAND, OR 97210-3236
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21103
OR
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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