Individual
JENNA RACHEL SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
887 MAIN ST, DALLAS, OR 97338-3110
(971) 241-3342
Mailing address
PO BOX 298, AMITY, OR 97101-0298
(971) 241-3342
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17640
OR
Other
Enumeration date
05/16/2007
Last updated
03/18/2011
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