Individual
JENNIFER L NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15110 BOONES FERRY RD, LAKE OSWEGO, OR 97035-3468
(971) 238-7662
Mailing address
470 RAILROAD AVE, MOUNT ANGEL, OR 97362-9543
(503) 984-4314
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23282
OR
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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