Individual
JASPER MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LMT
Contact information
Practice address
6744 SE MAPLEHURST RD, MILWAUKIE, OR 97222-1938
(971) 678-2842
Mailing address
6744 SE MAPLEHURST RD, MILWAUKIE, OR 97222-1938
(971) 678-2842
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
—
225700000X
Massage Therapist
Primary
18114
OR
374J00000X
Doula
—
—
Other
Enumeration date
08/22/2010
Last updated
07/21/2022
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