Individual
MS. JEANINE N VANSCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10340 SE DIVISION ST, PORTLAND, OR 97266-1269
(503) 232-1000
Mailing address
10340 SE DIVISION ST, PORTLAND, OR 97266-1269
(503) 232-1000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28124
OR
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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