Individual
DOMINIKA ROSE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1851 NE 8TH ST, BEND, OR 97701-4132
(541) 517-3183
Mailing address
1851 NE 8TH ST, BEND, OR 97701-4132
(541) 517-3183
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24424
OR
Other
Enumeration date
06/11/2018
Last updated
02/23/2023
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