Individual provider · Type 1 NPI

Daniel Leake, LMT

Massage Therapist · Gresham, OR

NPI number 1366830531 Active

Practice location

1217 NE Burnside Rd Ste 701D
Gresham, OR 97030-5770

Call (503) 348-4797 Map

Fax (503) 667-3403

Mailing address

1525 SE 139th Ave
Portland, OR 97233-2306

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X20278 (OR)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1366830531

Daniel Leake, LMT's National Provider Identifier is 1366830531, issued on Dec 22, 2014. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Gresham, OR. The record was last updated on Dec 22, 2014.