Organization
MEIGRA SIMON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEIGRA SIMON (OWNER)
(503) 775-1299
Entity
Organization
Contact information
Practice address
6842 SE HENRY ST, PORTLAND, OR 97206
(503) 775-1299
Mailing address
6842 SE HENRY ST, PORTLAND, OR 97206
(503) 775-1299
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
13081
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13081
MASSAGE THERAPY
OR
Enumeration date
03/30/2015
Last updated
03/30/2015
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