Individual
MR. JONATHAN GLEN CONANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
8283 SW BARBUR BLVD, PORTLAND, OR 97219-2871
(503) 244-1330
Mailing address
2804 NE 33RD AVE, PORTLAND, OR 97212-3650
(503) 998-7852
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC153627
OR
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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