Individual
MAKENNA SKYE JASZKOWIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2240 N INTERSTATE AVE STE 220, PORTLAND, OR 97227-1772
(503) 702-2001
Mailing address
8204 N PENINSULAR AVE APT 5, PORTLAND, OR 97217-6300
(208) 996-6820
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27973
OR
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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