Individual
BRYCE JONATHAN BUGBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4225 N COMMERCIAL AVE, PORTLAND, OR 97217-3027
(503) 447-6824
Mailing address
4225 N COMMERCIAL AVE, PORTLAND, OR 97217-3027
(503) 447-6824
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18896
OR
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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