Individual
JUNETTE E MCCOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, C.A.
Contact information
Practice address
790 E POWELL BLVD, GRESHAM, OR 97030-7616
(503) 618-0147
Mailing address
575 NE 2ND ST, GRESHAM, OR 97030-7511
(503) 666-4531
(503) 665-9997
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8270
OR
Other
Enumeration date
07/26/2011
Last updated
11/02/2012
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