Organization
SUNEYA WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA JACKSON DC, LMT (MANAGER)
(503) 894-9730
Entity
Organization
Contact information
Practice address
818 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-4357
(503) 894-9730
Mailing address
818 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-4357
(503) 894-9730
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
5642
OR
111N00000X
Chiropractor
Primary
5848
OR
225700000X
Massage Therapist
12773
OR
225700000X
Massage Therapist
12936
OR
Other
Enumeration date
04/28/2016
Last updated
10/21/2017
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