Individual
JENNA COLLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52660 NORTH RD, SCAPPOOSE, OR 97056-3416
(503) 961-3158
Mailing address
52660 NORTH RD, SCAPPOOSE, OR 97056-3416
(503) 961-3158
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22289
OR
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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