Individual
JANELLE LEE DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4356 COMMERCIAL ST SE, SALEM, OR 97302-3914
(503) 689-1216
Mailing address
2195 TURNAGE ST NW, SALEM, OR 97304-4520
(541) 915-5648
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19968
OR
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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