Individual
JENNIFER FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, LMT
Contact information
Practice address
6018 SE STARK ST, PORTLAND, OR 97215-1990
(503) 808-9145
(503) 473-8085
Mailing address
6018 SE STARK ST, PORTLAND, OR 97215-1990
(503) 808-9145
(503) 473-8085
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5652
OR
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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