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Individual

MS. JENNIFER L KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAC, LMT

Contact information

Practice address
2928 SE HAWTHORNE BLVD, SUITE 104, PORTLAND, OR 97214-4147
(503) 740-5464
Mailing address
2928 SE HAWTHORNE BLVD, SUITE 104, PORTLAND, OR 97214-4147
(503) 740-5464

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC150389
OR
225700000X
Massage Therapist
7221
OR

Other

Enumeration date
01/13/2010
Last updated
01/13/2010
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