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General NPI Number Information
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NPI Number | 1548645872
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Entity Type | Organization
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Legal Business Name | BENJAMIN MURPHY LMT
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 2516 NE CLACKAMAS ST
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City | PORTLAND
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State | OR
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Zip | 97232-1727
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Country | US
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Telephone | 805-358-4951
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Fax |
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Provider Business Mailing Address
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Address Line | 2516 NE CLACKAMAS ST
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City | PORTLAND
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State | OR
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Zip | 97232-1727
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Country | US
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Telephone | 805-358-4951
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | BENJAMIN MURPHY
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Credential | LMT
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Telephone | 805-358-4951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 19338
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License Number State | OR
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