Individual
JESSICA MARIE DIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3835 SW 185TH AVE STE 400, BEAVERTON, OR 97078-1553
(503) 626-2166
Mailing address
8443 NE HANCOCK ST, PORTLAND, OR 97220-5532
(615) 796-4666
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25750
OR
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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