Individual
JESSICA HAYWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6627 N ALBINA AVE, PORTLAND, OR 97217-1823
(541) 999-1677
Mailing address
6627 N ALBINA AVE, PORTLAND, OR 97217-1823
(541) 999-1677
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15013
OR
Other
Enumeration date
01/03/2016
Last updated
01/03/2016
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