Individual
MRS. JANELLE EVETTE GRIZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3821 NE MLK BLVD, PORTLAND, OR 97212-1114
(480) 586-7859
Mailing address
1453 N MAIN AVE, GRESHAM, OR 97030-3800
(480) 586-7859
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18608
OR
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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