Individual
JAYMI COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 NE BURNSIDE RD STE 301, GRESHAM, OR 97030-5705
(503) 492-2625
Mailing address
1217 NE BURNSIDE RD STE 301, GRESHAM, OR 97030-5705
(503) 492-2625
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC201895
OR
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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