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1699301119
ETHAN JEFFRIES
GRESHAM, OR
NPI
1699301119
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 25719)
Enumeration Date
2020-03-16
Last Update Date
2020-03-16
Business Address
ETHAN JEFFRIES LMT
4253 SE 182ND AVE
GRESHAM, OR 97030-5083
Phone number: 503-661-5090
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Mailing Address
ETHAN JEFFRIES LMT
892 E HISTORIC COLUMBIA RIVER HWY
TROUTDALE, OR 97060-2166
Phone number: 309-370-9379
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