Individual
JENNIFER MARY PETESKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
289 E ELLENDALE AVE STE 202, DALLAS, OR 97338-1541
(503) 751-1460
Mailing address
152 SW WYATT ST, DALLAS, OR 97338-1239
(503) 930-3246
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27256
OR
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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