Individual
JESSE WILLIAM BORJESSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2794 12TH ST SE, SALEM, OR 97302-3159
(503) 867-4457
(503) 391-9121
Mailing address
PO BOX 5591, SALEM, OR 97304-0591
(503) 867-4457
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12819
OR
Other
Enumeration date
04/13/2008
Last updated
07/11/2009
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