Individual
MS. JENNY L NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11365 SW CANYON RD, BEAVERTON, OR 97005-2235
(503) 781-4324
Mailing address
3404 19TH AVE, #218, FOREST GROVE, OR 97116-2030
(503) 781-4324
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8131
OR
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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