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Organization

JS STAFFORD ENTERPRISES, INC.

Active
Other names
J & S Center for Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SANDRA JEAN STAFFORD LMT (CEO)
(503) 829-5918
Entity
Organization

Contact information

Practice address
34952 S ELLIS RD, SUITE A, MOLALLA, OR 97038-8478
(503) 829-5918
Mailing address
34952 S ELLIS RD, SUITE A, MOLALLA, OR 97038-8478
(503) 829-5918

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
10643
OR
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5980280001
OR
01
612889300
DOL FECA #
Enumeration date
04/08/2008
Last updated
02/24/2010
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