Brian Soderholm, LMT

NPI #1053683813 in Gresham, Oregon

Provider Information

NPI Number: 1053683813
Entity Type: Individual
Name: Brian Soderholm, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Mechanotherapist
Credential: LMT
Enumeration Date: Feb 8, 2012
Last Updated: Feb 8, 2012

Practice Location

Address: 22400 SE STARK ST
City: Gresham
State: Oregon
ZIP Code: 97030-2656
Phone: (503) 491-5555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Mechanotherapist	172M00000X	Primary
Massage Therapist	225700000X

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