Mr. Jonathan Clark Grossart
Massage Therapist
1727 Ne 13th Ave Ste 101
Portland
, Oregon 97212-4378
Mr. Jonathan Clark Grossart
Massage Therapist
1727 Ne 13th Ave Ste 101
Portland
, Oregon 97212-4378
(503) 933-8066
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About
Features
Specialties
- Massage Therapist
Languages spoken
- English
Location
First Address
- Mr. Jonathan Clark Grossart
- 1727 Ne 13th Ave Ste 101
- Portland, OR
- Zip : 97212-4378
- Phone : (503) 933-8066
Second Address
- Mr. Jonathan Clark Grossart
- 1727 Ne 13th Ave Ste 101
- Portland, OR
- Zip : 97212-4378
- Phone : (503) 933-8066
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 13752 | OR |
National Provider Identifier
| NPI | 1013152032 |
|---|---|
| Provider Name | Mr. Jonathan Clark Grossart |
| First Address | Portland, OR 97212-4378 |
| Second Address | Portland, OR 97212-4378 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/12/2008 |
| Last Update Date | 01/11/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.