Individual
JENNIFER ROSE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
369 NE REVERE AVE STE 105, BEND, OR 97701-4082
(541) 323-3488
(541) 323-3483
Mailing address
369 NE REVERE AVE STE 105, BEND, OR 97701-4082
(541) 323-3488
(541) 323-3483
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15011
OR
Other
Enumeration date
03/30/2022
Last updated
12/04/2025
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