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Individual

JENNIFER DEE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
478 2ND ST, LAKE OSWEGO, OR 97034-3127
(918) 612-5378
Mailing address
295 3RD ST, 17, LAKE OSWEGO, OR 97034-3053
(917) 612-5378

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15174
OR

Other

Enumeration date
11/26/2010
Last updated
11/26/2010
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