Jason Lee Johnson, MASSAGE THERAPIST

NPI #1093950057 in Portland, Oregon

Provider Information

NPI Number
1093950057
Entity Type
Individual
Name
Jason Lee Johnson, MASSAGE THERAPIST
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Contractor
Credential
MASSAGE THERAPIST
Enumeration Date
Dec 4, 2008
Last Updated
Dec 4, 2008

Practice Location

Address
11120 NE HALSEY ST
State
Oregon
ZIP Code
97220-2021
Phone
(503) 252-5097

Specialties & Taxonomy Codes

Specialty
Contractor

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