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Individual

JESSICA SUZANNE PEDERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
812 NW 12TH ST, PENDLETON, OR 97801
(541) 310-8572
Mailing address
812 NW 12TH ST, PENDLETON, OR 97801-1232
(541) 310-8572

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
20139
OR
225700000X
Massage Therapist
Primary
60540879
WA

Other

Enumeration date
06/22/2015
Last updated
09/01/2018
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