Individual
JESSICA DAWN ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
115 NE A ST, GRANTS PASS, OR 97526-2111
(541) 659-3595
Mailing address
1750 REDWOOD AVE, GRANTS PASS, OR 97527-6049
(541) 659-3595
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023526
OR
Other
Enumeration date
02/17/2019
Last updated
10/31/2023
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