Individual
JENNIFER EBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3716 SE INTERNATIONAL WAY, MILWAUKIE, OR 97222-6001
(503) 659-0073
(503) 659-7471
Mailing address
6631 SE 48TH AVE, PORTLAND, OR 97206-7616
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14418
OR
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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