Individual
JANAY R JENNICHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
960 LIBERTY ST SE, SUITE 170, SALEM, OR 97302-4171
(503) 588-6633
Mailing address
1113 SE HOLMAN AVE, DALLAS, OR 97338-2610
(503) 421-2928
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20926
OR
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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