Individual
JENNIFER LYNN HABADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4317 NE TILLAMOOK ST, PORTLAND, OR 97213-1315
(503) 493-9730
Mailing address
4317 NE TILLAMOOK ST., PORTLAND, OR 97213
(503) 493-9730
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
18127
OR
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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