Individual
JENELLE NOEL COCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
622 CALIFORNIA AVE, VERNONIA, OR 97064-6000
(971) 400-5618
Mailing address
233 SE WASHINGTON ST, HILLSBORO, OR 97123-4023
(503) 352-9685
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18835
OR
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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