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Individual

JASEN JOHN KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
200 E 2ND ST, NEWBERG, OR 97132-3083
(971) 241-1232
Mailing address
1304 N COLLEGE ST, NEWBERG, OR 97132-9101
(971) 241-1232

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19073
OR

Other

Enumeration date
03/11/2013
Last updated
03/11/2013
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