Individual
JANA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2933 NE BROADWAY ST, PORTLAND, OR 97232-1760
(503) 765-5791
Mailing address
2933 NE BROADWAY ST, PORTLAND, OR 97232-1760
(503) 765-5791
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24679
OR
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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