Daniel Edwards
Massage Therapist in Beaverton, OR. Individual provider (NPI-1).
NPI number1073078614
StatusActive
Last updated in NPPESFeb 7, 2019
Details
- NPI
- 1073078614
- Entity type
- Individual (NPI-1)
- Name
- Daniel Edwards
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 7, 2019
- Last updated
- Feb 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 22660 | OR | Yes |
Practice location
4655 Sw Griffith Dr Ste 180Beaverton, OR 97005-8732
Phone 503-746-5214
Mailing address
12430 Sw Ash Ave Apt 25Tigard, OR 97223-6237
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