Individual
JANUARY L LOOMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
16552 BOONES FERRY RD, LAKE OSWEGO, OR 97035-4294
(503) 675-3559
Mailing address
16552 BOONES FERRY RD, LAKE OSWEGO, OR 97035-4294
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7804
OR
Other
Enumeration date
11/02/2008
Last updated
11/02/2008
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