Individual
JENNA LARI JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12662 SW 127TH AVE, TIGARD, OR 97223-1859
(832) 773-3784
Mailing address
12662 SW 127TH AVE, PORTLAND, OR 97223-1859
(832) 773-3784
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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