Individual
JACLYN LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3694 PACIFIC HWY, HUBBARD, OR 97032-9302
(503) 980-2000
Mailing address
185 N 2ND ST, WOODBURN, OR 97071-4737
(503) 939-6526
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18355
OR
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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