Individual
JASPER MARIE GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
13112 NE HALSEY ST, PORTLAND, OR 97230-2350
(503) 252-3952
(503) 252-3052
Mailing address
13112 NE HALSEY ST, PORTLAND, OR 97230-2350
(503) 252-3952
(503) 252-3052
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14431
OR
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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