Individual
JITTRA BOONNIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9600 SW OAK ST STE 410, TIGARD, OR 97223-6581
(503) 308-8676
Mailing address
1930 S RIVER DR UNIT 306, PORTLAND, OR 97201-8054
(971) 222-9600
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27324
OR
Other
Enumeration date
02/09/2023
Last updated
01/02/2026
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