Individual
JAMIE PAULINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, BA
Contact information
Practice address
4340 SE MADISON ST, PORTLAND, OR 97215-2431
(503) 477-7037
Mailing address
4340 SE MADISON ST, PORTLAND, OR 97215-2431
(503) 477-7037
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16341
OR
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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