Individual
MS. JACQUELINE R BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
17733 NW PUMPKIN RIDGE RD, NORTH PLAINS, OR 97133-6155
(503) 804-8048
Mailing address
17733 NW PUMPKIN RIDGE RD, NORTH PLAINS, OR 97133-6155
(503) 804-8048
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10754
OR
Other
Enumeration date
07/25/2009
Last updated
07/25/2009
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