Individual
MS. JESSICA ANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
11804 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9308
(503) 454-0782
Mailing address
11804 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9308
(503) 454-0782
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
158023
OR
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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