Individual
MRS. HOLLEY JEAN DESHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
559 GLATT CIR, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Mailing address
PO BOX 315, MOUNT ANGEL, OR 97362-0315
(503) 407-1821
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10890
OR
Other
Enumeration date
07/22/2006
Last updated
07/08/2007
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