Individual
JANE SYLVIA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
909 N BEECH ST STE 201, PORTLAND, OR 97227-1115
(503) 481-3964
Mailing address
909 N BEECH ST STE 201, PORTLAND, OR 97227-1115
(503) 481-3964
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/10/2018
Last updated
11/10/2018
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