Individual
JEANNINE BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1717 CENTENNIAL BLVD STE 4, SPRINGFIELD, OR 97477-3378
(541) 505-2756
Mailing address
1717 CENTENNIAL BLVD STE 4, SPRINGFIELD, OR 97477-3378
(541) 505-2756
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23705
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23705
LICENSED MASSAGE THERAPIST
OR
Enumeration date
09/10/2017
Last updated
02/09/2023
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