Organization
MASON MOORE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASON MOORE LAC, LMT (MANAGER)
(503) 748-9399
Entity
Organization
Contact information
Practice address
1235 SE DIVISION ST STE 206, PORTLAND, OR 97202-1089
(503) 748-9399
Mailing address
2100 SE BELMONT ST APT 410, PORTLAND, OR 97214-4572
(503) 748-9399
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC184969
OR
225700000X
Massage Therapist
LMT20000
OR
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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