Individual
JILL L FESSENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, LMT, ABLS
Contact information
Practice address
3835 NE HANCOCK ST, GLB, PORTLAND, OR 97212-5319
(503) 288-8586
(503) 288-8586
Mailing address
3835 NE HANCOCK ST, GLB, PORTLAND, OR 97212-5319
(503) 288-8586
(503) 288-8586
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19119
OR
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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