Individual
MRS. JESSICA ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
13131 SE 125TH AVE, CLACKAMAS, OR 97015-9324
(503) 756-9494
Mailing address
10728 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9781
(503) 756-9494
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9341
OR
Other
Enumeration date
06/22/2008
Last updated
07/12/2010
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