Individual
MS. JACKI GETHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT CADC1
Contact information
Practice address
10900 SW NORTH DAKOTA ST, TIGARD, OR 97223-4121
(503) 790-0974
Mailing address
PO BOX 11208, PORTLAND, OR 97211-0208
(503) 790-0974
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
#3915
OR
Other
Enumeration date
07/07/2007
Last updated
07/08/2007
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