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Contact Information

JASON MAYBERRY, LMT
4445 SW BARBUR BLVD
SUITE 104
PORTLAND, OR97239-4047
 Phone: 503-226-4500
 Fax: 503-226-0796
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mechanotherapist

172M00000X
Indicates primary specialty

NPI Profile & details for JASON MAYBERRY · (Male)

NPI Number 1235462722
Status Active
Credentials LMT (Licensed Massage Therapist)
Entity Individual
Enumeration date 09/15/2009
Last updated 09/15/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 11108
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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