Individual
JESSICA AMY GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
3944 N MISSISSIPPI AVE, PORTLAND, OR 97227-1163
(503) 517-8222
(503) 517-8223
Mailing address
3944 N MISSISSIPPI AVE, PORTLAND, OR 97227-1163
(503) 517-8222
(503) 517-8223
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
13866
OR
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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