Individual
MISS JENNIFER MARIE WOLJEVACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
522 NW 12TH AVE, PORTLAND, OR 97209-3001
(503) 318-2973
Mailing address
522 NW 12TH AVE, PORTLAND, OR 97209-3001
(503) 318-2973
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
11784
OR
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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