Individual
JACQULYN MAXINE MCDOUGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8755 SW CHRISTINE DR, SUITE 102, WILSONVILLE, OR 97070
(503) 682-1110
(503) 682-1118
Mailing address
7149 SW SAGERT ST, SUITE 103, TUALATIN, OR 97062-8261
(503) 706-3833
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
1582
OR
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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