Individual
JESSICA MAYE WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
375 NE FRANKLIN AVE, BEND, OR 97701-4917
(541) 699-1013
Mailing address
3995 NW LOWER VILLAGE RD, BEND, OR 97703-9070
(541) 699-1013
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24411
OR
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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