Healthcare Provider Details

I. General information

NPI: 1780958272
Provider Name (Legal Business Name): RICK QUINTON SNOOK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18005 SW FITCH DR
SHERWOOD OR
97140-8860
US

IV. Provider business mailing address

22000 WILLAMETTE DR 107
WEST LINN OR
97068-3275
US

V. Phone/Fax

Practice location:
  • Phone: 503-925-9237
  • Fax:
Mailing address:
  • Phone: 503-722-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: