Individual
JESSICA RUTH RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2122 NW QUIMBY ST, PORTLAND, OR 97210-2622
(503) 292-7668
Mailing address
2112 NW QUIMBY ST APT 417, PORTLAND, OR 97210-2377
(530) 917-3780
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23704
OR
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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