NATHAN DAVID BANTA

CLACKAMAS, OR
NPI1174486120
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225700000X Massage Therapist
(Licence: OR  28831)
Enumeration Date2025-12-06
Last Update Date2025-12-06
Business Address
NATHAN DAVID BANTA LMT
9895 SE SUNNYSIDE RD STE K
CLACKAMAS, OR 97015-9745
Phone number: 503-653-0400
Mailing Address
NATHAN DAVID BANTA LMT
2195 NW 18TH AVE APT 652
PORTLAND, OR 97209-2478
Phone number: 503-660-6845
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