Individual
JENNIFER MARIE BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
5331 SW MACADAM AVE, SUITE 105, PORTLAND, OR 97239-6104
(503) 445-7999
(503) 445-7997
Mailing address
5331 SW MACADAM AVE, SUITE 105, PORTLAND, OR 97239-6104
(503) 445-7999
(503) 445-7997
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7252
OR
Other
Enumeration date
06/03/2010
Last updated
12/26/2012
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