Healthcare Provider Details

I. General information

NPI: 1992621312
Provider Name (Legal Business Name): ALEC MICHAEL OSCAR BARTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 SW GRIFFITH DR STE 180
BEAVERTON OR
97005-8732
US

IV. Provider business mailing address

1834 SW 5TH AVE APT 101
PORTLAND OR
97201-5253
US

V. Phone/Fax

Practice location:
  • Phone: 503-746-5214
  • Fax:
Mailing address:
  • Phone: 458-250-5261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number28668
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: