Organization
MASSAGE AND SPA AT BETHANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L OULDS LMT (OWNER/THERAPIST)
(503) 533-5614
Entity
Organization
Contact information
Practice address
15280 NW CENTRAL DR, 102, PORTLAND, OR 97229-7805
(503) 533-5614
Mailing address
15280 NW CENTRAL DR, 102, PORTLAND, OR 97229-7805
(503) 533-5614
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
20527
OR
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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