Individual
JANA R LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
281 W OREGON AVE, CRESWELL, OR 97426-9605
(541) 521-4405
(541) 225-5339
Mailing address
PO BOX 716, CRESWELL, OR 97426-0716
(541) 521-4405
(541) 225-5339
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15994
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15994
STATE OF OREGON
OR
Enumeration date
01/13/2011
Last updated
10/03/2020
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