Individual
JACKIEBLU LOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
619 NE BAKER ST STE B, MCMINNVILLE, OR 97128-4949
(971) 267-5375
Mailing address
527 NW CYPRESS ST, MCMINNVILLE, OR 97128-5464
(971) 237-9394
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19526
OR
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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