Individual
CARLA JEANNETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2715 NW 19TH AVE, ALBANY, OR 97321-9694
(503) 507-0518
Mailing address
2715 NW 19TH AVE, ALBANY, OR 97321-9694
(503) 507-0518
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26821
OR
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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