Individual
MRS. JENEANE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA, C-SLPA, B.S.
Contact information
Practice address
290 MOYER LN NW, SALEM, OR 97304-3822
(503) 370-8990
Mailing address
290 MOYER LN NW, SALEM, OR 97304-3822
(503) 370-8990
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7583
OR
2355S0801X
Speech-Language Assistant
A0257
OR
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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