Individual
MRS. JENNIFER LYNNE NANIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1012 TREVITT ST, THE DALLES, OR 97058-1463
(541) 296-6495
(541) 296-6497
Mailing address
1012 TREVITT ST, THE DALLES, OR 97058-1463
(541) 296-6495
(541) 296-6497
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14616
OR
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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