Provider Demographics
NPI:1104051796
Name:MASSEY, JAMES BRIAN (ND)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRIAN
Last Name:MASSEY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 SW VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-2948
Mailing Address - Country:US
Mailing Address - Phone:503-292-7272
Mailing Address - Fax:503-297-4788
Practice Address - Street 1:3310 SW VISTA DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2948
Practice Address - Country:US
Practice Address - Phone:503-292-7272
Practice Address - Fax:503-297-4788
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0681175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath