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Individual

MRS. JENNIFER LYN EDMONDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
812 SE 48TH AVE, PORTLAND, OR 97215-1724
(503) 236-2624
Mailing address
7318 N SYRACUSE ST, PORTLAND, OR 97203-5068
(206) 930-8246

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
08638
OR

Other

Enumeration date
08/09/2022
Last updated
08/09/2022
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