Individual
JESSICA SUDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1880 LANCASTER DR NE, SALEM, OR 97305-1089
(503) 589-0700
(503) 586-0255
Mailing address
1880 LANCASTER DR NE, SALEM, OR 97305-1089
(503) 589-0700
(503) 586-0255
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20170
OR
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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