Individual
JENIFER MARI MYLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
5117 SE POWELL BLVD STE 5B, PORTLAND, OR 97206-3000
(503) 683-2738
Mailing address
1636 SE 52ND AVE, PORTLAND, OR 97215-3318
(503) 740-5738
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC183247
OR
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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