Individual
JESSE VANDENBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
61239 TETHEROW DR STE 208, BEND, OR 97702-3734
(541) 393-9648
Mailing address
1630 NW PORTLAND AVE, BEND, OR 97703-1409
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28374
OR
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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