Individual
PATRICIA BETH FUENTES JIMMIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
619 HIGH ST, OREGON CITY, OR 97045-2240
(503) 656-4993
(503) 657-0411
Mailing address
2215 SE MILLER ST, PORTLAND, OR 97202-6873
(503) 522-7351
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023252
OR
Other
Enumeration date
09/17/2017
Last updated
09/17/2017
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