Individual
MS. JESSICA IRENE SCOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
289 E ELLENDALE AVE STE 102, DALLAS, OR 97338-1500
(503) 623-5505
Mailing address
473 SE EXCEL ST, SHERIDAN, OR 97378-1963
(971) 237-2751
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16026
OR
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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