Individual
GREGORY PATRICK ANGNOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1605 NORTHEAST BROADWAY STREET, PORTLAND, OR 97232-1425
(503) 756-8960
Mailing address
3636 SE 65TH AVE, PORTLAND, OR 97206-2748
(503) 756-8960
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18432
OR
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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