Individual
JESSICA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
612 N 1ST ST, SILVERTON, OR 97381-1404
(503) 873-4381
Mailing address
3985 BLANCHE LN NE, SALEM, OR 97305-3292
(503) 871-0428
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22454
OR
Other
Enumeration date
06/29/2019
Last updated
06/29/2019
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