NPI 1073744967

Phoenix Greenman, LMT

Practitioner Mechanotherapist Portland, OR

Practice location

Address: 3327 SE Hawthorne Blvd, Portland, OR 97214-5046
Phone: (503) 577-5512
Mailing address: 836 NE 78th Ave, Portland, OR 97213-6957

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 15823 (OR)

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Registry record

NPI: 1073744967
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jul 2009
Record last updated: 27 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.