Individual
JEANETTE ANN SLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1920 N KILLINGSWORTH ST, PORTLAND, OR 97217-4437
(971) 279-2757
Mailing address
1920 N KILLINGSWORTH ST, PORTLAND, OR 97217-4437
(971) 279-2757
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19805
OR
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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