Individual
JESSICA ERIN MACISAAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
2794 12TH ST SE, SALEM, OR 97302-3159
(503) 566-8456
(503) 931-9121
Mailing address
1370 EMMONS DR NE, SALEM, OR 97301-2900
(503) 569-1094
(503) 391-9121
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13380
OR
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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