Individual
MATTHEW KERRIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4922 N VANCOUVER AVE, PORTLAND, OR 97217-2826
(503) 493-9398
Mailing address
4922 N VANCOUVER AVE, PORTLAND, OR 97217-2826
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18312
OR
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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