MEDICARE: DR. JAMES BRIAN MASSEY ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	0681	OR

General Provider Information

NPI Number	:	1104051796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BRIAN MASSEY ND

Provider Business Mailing Address
First Line	:	3310 SW VISTA DR
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97225-2948
Country	:	US
Telephone Number	:	503-292-7272
Fax Number	:	503-297-4788

Provider Business Practice Location Address
First Line	:	3310 SW VISTA DR
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97225-2948
Country	:	US
Telephone Number	:	503-292-7272
Fax Number	:	503-297-4788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	05/26/2009

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