Individual
JACKSON LESTER WORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2100 SE LAKE RD STE 1, MILWAUKIE, OR 97222-7759
(503) 344-6711
(503) 926-9365
Mailing address
2100 SE LAKE RD STE 1, MILWAUKIE, OR 97222-7759
(503) 344-6711
(503) 926-9365
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24980
OR
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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