Individual
JENNIFER ELIZABETH NISLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 SW SPRING GARDEN ST STE 100, PORTLAND, OR 97219-3966
(503) 841-6222
Mailing address
2505 SW SPRING GARDEN ST STE 100, PORTLAND, OR 97219-3966
(503) 841-6222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26575
OR
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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