Individual
JODI LYNN MCKEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 MONROE PKWY STE U, LAKE OSWEGO, OR 97035-8875
(503) 387-3205
Mailing address
61 BENTHAVEN PL, BOULDER, CO 80305-6255
(303) 819-2924
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
0019093
CO
225700000X
Massage Therapist
Primary
25938
OR
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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