Individual provider · Type 1 NPI

Ian Dougherty

Massage Therapist · Portland, OR

NPI number 1578800405 Active

Practice location

2037 N Williams Ave
Portland, OR 97227-1929

Call (503) 287-3813 Map

Mailing address

375 NE Shaver St Apt 608
Portland, OR 97212-1080

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X18078 (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 1578800405

Ian Dougherty's National Provider Identifier is 1578800405, issued on Jan 11, 2013. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Jan 11, 2013.