| NPI | 1023552411 |
|---|---|
| Doing Business As | HEALTHSOURCE OF PORTLAND EAST |
| Entity Type | Organization |
| Authorized Contact | ANTHONY QUANG PHAM Chiropractor 503-975-5298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 86224) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |