Individual
JACKSON SOMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7318 N LEAVITT AVE, PORTLAND, OR 97203-4840
(503) 567-5880
(866) 629-1294
Mailing address
7318 N LEAVITT AVE, PORTLAND, OR 97203-4840
(503) 567-5880
(866) 629-1294
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29282
OR
Other
Enumeration date
12/12/2025
Last updated
12/12/2025
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